Actuarial Analyst, Senior

Job Category:
Actuarial Services

The Actuarial Provider Strategies team supports the budget setting, program design, and operations of Blue Shield of California’s value-based care (VBC) payment models, which includes Accountable Care Organization (ACO) and other innovative, alternative payment models. The Actuarial Analyst – Senior will report to the Principal of Actuarial Provider Strategies. In this role you will have responsibility evaluating the performance of Blue Shield of California’s value-based care models, including cost, utilization and quality assessment.

Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques. Support the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up. Perform data exploration using a combination of statistical programming languages (including, but not limited, R, Python, SQL, SAS) and deploy actuarial and statistical techniques to evaluate the value-based care models with clear outcome and deliverable.

Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports. Support production of the final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience’s understanding for all of Blue Shield of California’s value-based care models. This can be done via presentations, memos, external publications, or all the above. Research clinical and financial outcomes from others like value-based care programs in the industry.

Work with other colleagues from different areas to solve business problems; this may involve presenting either verbally or in written format to key stakeholders or leadership.

• Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Requires at least 3 years of professional actuarial experience
• Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL
• Requires strong communication and presentation skills
• Requires strong ability to communicate complex technical subjects to non-technical audiences
• Desires some level of experience in Visualization tool like Tableau and Machine Learning basics
• Desires a curious mindset and eagerness to learn
• Prior healthcare industry experience preferred

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan;
Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve.

We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair
360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we’re going to do and by acknowledging and correcting…