What are the responsibilities and job description for the Actuarial Analyst, Senior position at Blue Shield Of California?
Your RoleIs this your next job Read the full description below to find out, and do not hesitate to make an application.The Network and Provider Analytics team drives the development of an affordable provider network through data analytics and expertise. The Senior Actuarial Analyst will report to the Senior Manager. In this role you will perform financial analyses and modeling for CalPERS provider contracting support including term changes, renewals, network changes, and terminations for hospitals, ambulatory surgery centers and other types of providers.Your WorkIn this role, you will : Understand the core principles and functionality of decision, descriptive and predictive analytic methods including forecasting, statistical and machine learning techniquesConduct 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 analysisCoordinate, 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 strategiesPerform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploys 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 efficienciesDevelop evaluation and financial reporting standards for internal and external reportsConduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reportsDevelop documentation and create and execute workplans for analyses of high complexityCreate financial unit cost trend reporting and rate calculations under moderate supervision using Excel modeling toolsRun and maintain SAS queries to gather data required for complex financial analysisReprice historical data against provider contract terms based on deep understanding on contract structure and configurationAnalyze CalPERS PPO contract rate proposals from hospitals and ambulatory surgery centers to assess the financial and trend impactPartner with network management department in maintaining and developing the CalPERS PPO provider network and contracting strategyYour Knowledge and ExperienceRequires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experienceRequires a minimum of 3 years of professional actuarial experienceRequires 2 years of experience in Health Care (managed care, academic, or government payer)Requires eperience analyzing healthcare claims data, trends, and forecastingRequires proficiency in Exce and comfort working with large data setsKnowledge of SAS is preferredPay Range : The pay range for this role is : $ 99000.00 to $ 148500.00 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.
Salary : $99,000 - $148,500
