Actuarial Analyst III

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us.

We pride ourselves on our best‑in‑class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

This Senior Actuarial Analyst position resides within the Actuarial Department and plays a key role in supporting premium rate development and pricing strategies for the Large Group market. The role is responsible for analyzing and evaluating proposed benefit and cost‑sharing changes, conducting pricing and financial impact studies, assessing the implications of state and federal legislative and regulatory changes, and supporting Mental Health Parity compliance reviews.

Working closely with actuarial, finance, product, and regulatory teams, this position applies advanced actuarial methodologies, statistical analysis, and predictive modeling techniques to assess risk, evaluate financial outcomes, and support data‑driven business decisions. The Senior Actuarial Analyst also contributes to a variety of strategic and operational initiatives, helping ensure pricing accuracy, regulatory compliance, and the long‑term financial sustainability of the organization’s products and programs.

• Assist in the development and maintenance of premium rates for the Individual and Small Group markets.
• Support the preparation, validation, and submission of premium rate filings to state and federal regulatory agencies.
• Analyze and evaluate proposed benefit design and cost‑sharing changes to determine financial and actuarial impacts.
• Conduct pricing analyses, actuarial studies, and financial modeling to support product and rate development initiatives.
• Assess the impact of proposed state and federal legislative, regulatory, and healthcare reform changes on pricing and product strategy.
• Perform Mental Health Parity compliance reviews and support related regulatory reporting requirements.
• Conduct experience analyses and drill‑down studies to identify emerging trends, utilization patterns, and key cost drivers.
• Develop ad hoc actuarial models and analytics to support strategic decision‑making and business initiatives.
• Collaborate with Product, Finance, Underwriting, Regulatory, Compliance, and other business partners to evaluate assumptions and recommendations.
• Review and analyze data from multiple sources to support actuarial projections and risk assessments.
• Prepare reports, presentations, and recommendations for management, clearly communicating complex actuarial concepts and analytical findings.
• Support additional actuarial projects and initiatives as assigned by department leadership.
• Apply actuarial principles, statistical methods, and mathematical modeling techniques to evaluate risk and support sound business decisions.

• Bachelor’s degree in Mathematics, Statistics, Actuarial Science, Economics, Finance, or a related quantitative field from an accredited college or university, or an equivalent combination of education and relevant experience.
• Minimum of four (4) years of actuarial, statistical, healthcare analytics, or related quantitative experience.
• Progress toward Associate of the Society of Actuaries (ASA) designation preferred.
• Experience supporting actuarial pricing, modeling, forecasting, or financial analysis initiatives.

• Experience with in the health insurance or managed care industry.
• Working knowledge of premium rate development, healthcare pricing, and actuarial methodologies.
• Familiarity with state and federal regulatory requirements related to health insurance products.
• Progress toward or attainment of ASA designation strongly preferred.
• Certifications Associate of the Society of Actuaries…