Actuarial Analyst, Experienced Job at Blue Shield of California, Oakland, CA

bUJBcjRGb1d6RHh5WlRqVDlQTE8vKzU2dlE9PQ==
  • Blue Shield of California
  • Oakland, CA

Job Description

Your Role

 

The Risk Adjustment Analytics & Reporting team is looking for an Experienced Actuarial Analyst. The Experienced Actuarial Analyst will report to the Manager of Risk Adjustment Analytics & Reporting. In this role you will create and own various analytical projects that assist providers in accurately capturing the risk score of their member populations. Additional responsibilities include supporting the member suspecting process as well as supporting Blue Shield’s prospective programs.

Your Work

 

In this role, you will:

  • Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques
  • Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis
  • Coordinate, prepare, perform and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of pricing, trending, reserving, provider reimbursement and/or risk assessment strategies
  • Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting 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
  • Perform other responsibilities as assigned

Your Knowledge and Experience

  • Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
  • Requires at least 2 years of professional actuarial experience
  • Requires one to be an independent, proactive problem solver with patience for working on large scale problems
  • Requires strong technical skills
  • Programming knowledge required (SAS and/or VBA preferred), including sample code (in any language)
  • Requires proficiency with Microsoft Excel
  • Preferred 4+ exams completed in the Society of Actuaries exam process (but not required)

Job Tags

Similar Jobs

BECCA MGMT

Talent Coordinator Job at BECCA MGMT

 ...About Us: BECCA MGMT is a full-service digital talent management company, dedicated to empowering creators through strategic brand...  ...operations of BECCA MGMT, as you will liaise between talent and brands/agencies and third parties to ensure streamlined communications and a... 

Alive and Well Health

Weekend Spa Housekeeping Attendant - Alive and Well Dallas Weekend Spa Housekeeping Attendant - Aliv Job at Alive and Well Health

 ...Job Description Job Description Spa Housekeeping Attendant (Dallas) Alive and Well is the largest integrative functional wellness center and spa in Texas with a mission to Empower and Elevate Human Health so that those we serve can live from their highest purpose... 

Pacific Bells

Restaurant General Manager Job at Pacific Bells

 ...Taco Bell GET ALL-ACCESS TO: + Same day pay- Hourly Team Members never have to wait for a paycheck again! Work today, get paid tomorrow! With DailyPay, Pacific Bells hourly Team Members have access to their pay on day 1 of work. Make any day payday. Enjoy our most... 

Recruits Lab

Imaging Service Engineer II Job at Recruits Lab

 ...(On-site) Job Type: Full-Time | Direct Hire Industry: Hospital & Health Care Experience Level: Mid-Senior Education Required...  ..., devices, systems, and instruments Perform preventative maintenance and ensure equipment is functioning optimally and safely... 

CVS Health

Customer Service Team Lead (Meritain Health) Job at CVS Health

 ...proficiently and effectively.+ Monitor and review calls to ensure quality control measures are in...  ...of experience in a customer service call center environment.+ Working knowledge of...  ...Qualifications**+ Experience in the healthcare industry.+ Experience with self-funded or...