Job Description

Your Role

The Risk Adjustment Analytics and Reporting team is looking for an Associate Actuarial Analyst. The Associate Actuarial Analyst will report to the Manager of Risk Adjustment Analytics. In this role you will create and own various analytical projects that assist providers in accurately capturing the risk score of their populations. Additional responsibilities include other related work to help the company achieve its financial and membership targets.

Your Work

In this role, you will:

• Learn various actuarial techniques and procedures by: conducting analysis, assessing risk and population risk scores and assignment, developing pricing and trends, assessing changes in benefit designs, developing reserves, performing forecasting, analyzing provider reimbursement terms and/or evaluating actuarial risk related analysis
• Compile and categorize data, documenting and verifying the factors used in computations such as those used in evaluating loss and expense reserves, preparing rate filings, schedules of statistics, premiums, benefits, member risk data and score submissions and establishing rating and pricing levels
• Produce timely various standard analytic reports for internal and/or external use
• Study for exams towards credentials
• Understand the core principles and functionality of decision, descriptive, predictive, and prescriptive analytic methods including forecasting, statistical, and machine learning techniques
• Coordinate, prepare, perform, and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of risk assessment strategies
• Perform data exploration using a combination of statistical programming languages (including, but not limited to: R, Python, SQL, and SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction in a manner that is actuarially sound, and enable real-time results and operational efficiencies
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
• Quantify and project risk scores and revenue for the Medicare line of business
• Conduct complex actuarial analyses to assess risk scores, including performing root cause analysis
• Create data-driven solutions for capturing risk and improving quality of care for our members
• Perform vendor return on investment analyses to determine ongoing benefit and decision support

Your Knowledge and Experience

 

• Requires a bachelor's degree in mathematics, statistics, computer science or related discipline or equivalent business experience
• Typically, has completed 1 to 2 courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation
• No previous professional actuarial experience required but typically has obtained broad theoretical job knowledge through advanced education

Pay Range:

The pay range for this role is: $ 31.73 to $ 44.41 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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