Role OverviewThe Actuarial Pay for Value team serves as a strategic partner to Blue Shield leadership in designing and advancing innovative payment models, value-based care strategies, provider incentives, and new program concepts that improve affordability, quality, provider performance, and member outcomes across the enterprise. The Actuarial Analyst, Consultant will report to the Senior Manager, Actuarial Pay for Value. In this role, you will serve as a lead actuarial subject matter expert responsible for shaping enterprise payment and value-based care strategies, developing new program concepts, evaluating financial impact, and translating innovative ideas into scalable solutions that improve affordability, quality, provider performance, and member outcomes.
What You Will Do
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 evaluate actuarial risk related analysis.
Why It Might Be a Fit
You will partner cross-functionally with business, clinical, operational, technology, finance, and provider stakeholders to guide complex workstreams from concept through implementation, influence recommendations, navigate ambiguity, and provide direction and review for junior team members.
Requirements
- Understanding of decision, descriptive, predictive, and prescriptive analytic methods
- Experience with forecasting, statistical and machine learning techniques
- Ability to conduct and develop analysis, assess risk and population risk scores and assignment
- Experience with actuarial risk related analysis
- Experience with analytical programming languages including Python, SQL, and SAS
- Experience with predictive analytics and machine learning techniques
- Ability to direct, coordinate, and/or develop evaluation and financial reporting standards
- Experience with data exploration and deployment of predictive analytics and machine learning techniques
Benefits
- Actuarial Analyst, Consultant
- Full time
- Oakland, CA, United States; CA, United States
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