Principal Actuary - Medicaid

Job Description

We're seeking a strategic and technically experienced Principal Actuary to lead complex actuarial work that informs key business decisions across our organization. In this role, you will apply advanced expertise in mathematics, probability, statistics, and health insurance to guide sophisticated pricing, valuation, and financial forecasting initiatives.

Blue Cross NC's Medicaid lines of business are administered through a joint partnership with another health plan. The other health plan provides the actuarial services for Medicaid. This position will be the first Medicaid actuarial position on the Blue Cross NC side, and is intended to work closely with our partner plan to interpret reserving results and trends, and ensure Blue Cross NC leadership is able to understand run-rate analysis, apply appropriate accounting and financial reporting treatments, and understand drivers of financial variance and trends.

This actuary will report into the Valuation/Reserving function.

• Actively contribute to the success of the Actuarial Services team.
• Responsible for handling highly complex actuarial modeling.
• Lead and/or provide consultative support to assigned projects and be viewed as an expert in the field.
• Assist in Rating/Pricing
• Develop/Maintain rating models
• Perform Medical Trend analysis
• Support Administrative Expense factor development
• Conduct Experience Studies
• Conduct Rating Factor Studies
• Support Rate Filing development
• Assist in support for Financial Forecasting
• Work with FP&A to support development of Plan forecast for assigned segments
• Assist in support for Network Management
• Support evaluation of financial impacts of provider contract changes
• Assist in support for Underwriting (all segments)
• Provide ad hoc support for underwriting requests
• Assist in support for Sales and Marketing
• Provide support for new product development
• Provide support for new/existing product programs
• Continuing Education
• Responsible for maintaining continuing education requirements as set by the appropriate Actuarial governing body (i.e. Society of Actuaries)
• Is a participant in good standing in the Actuarial Development Program, if still pursuing the FSA designation

• Bachelor's degree or advanced degree (where required)
• Associate of the Society of Actuaries (ASA) and Member of the American Academy of Actuaries (MAAA)
• 5+ years of experience in related field
• In lieu of an ASA, alternate actuarial credentials may be considered.
• In lieu of 5 years of experience, may consider candidates who are Fellows of the Society of Actuaries (FSA).

• Prior experience with Medicaid Highly Preferred
• Prior experience in Health Reserving Highly Preferred
• Prior experience with Financial Reporting & Accounting Highly Preferred

• The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.
• Work-life balance, flexibility, and the autonomy to do great work.
• Medical, dental, and vision coverage along with numerous health and wellness programs.
• Parental leave and support plus adoption and surrogacy assistance.
• Career development programs and tuition reimbursement for continued education.
• 401k match including an annual company contribution
• Learn more

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

* Based on annual corporate goal achievement and individual performance.

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Actuarial Pricing, Actuarial Science, Financial Data Reporting, Financial Reporting and Analysis, Medicaid, Underwriting