Blue Shield of California · 4 hours ago
Actuarial Analyst, Experienced
Oakland, CA, United States
Full-time
Hybrid
Entry, Mid Level
$42.11/hr - $63.16/hr
2+ years expBlue Shield of California is a nonprofit organization committed to transforming healthcare to be more affordable and effective. The Actuarial Analyst, Experienced will perform financial analyses and modeling for provider contracting support, including assessing risk and developing pricing strategies.
Financial ServicesHealth InsuranceNon Profit
No H1B
Responsibilities
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
Create financial unit cost trend reporting and rate calculations using Excel modeling tools
Reprice historical data against provider contract terms based on deep understanding on contract structure and configuration
Analyze contract rate proposals from hospitals and ambulatory surgery centers to assess the financial and trend impact
Partner with network management department in maintaining and developing the provider network and contracting strategy
Qualification
Required
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
Typically, has completed 3 courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation
Requires proficiency in Excel and comfort working with large data sets
Preferred
Knowledge of SAS is preferred
Experience analyzing healthcare claims data, trends, and forecasting preferred
Company
Blue Shield of California
Blue Shield of California is a health insurance service provider.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Gary Culp
Senior Vice President, Government Markets
Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
Recent News
2026-01-13
Fierce Healthcare
2025-12-15
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