Actuarial Analyst, Experienced

Your Role

The Value Based Care (VBC) Analytics team supports new and innovative payment models, including Accountable Care Organizations (ACO), Virtual Care, and other performance-based incentive programs. The Actuarial Analyst, Experienced, will report to the Value Based Care Analytics Senior Manager. In this role you will support VBC strategies by developing, validating, and maintaining analytic datasets and reporting that inform provider performance on utilization and financial metrics.

You will collaborate with a diverse team across multiple roles and functions within the company.

Your Work

In this role, you will:

• Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
• Own data pulls, quality checks, and documentation across claims, provider, membership, and risk score sources
• Draft exhibits and narratives for ACA/CMS and state filings, submissions, and internal governance reviews
• Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
• Translate results into clear summaries for more senior actuaries and business partners
• Improve workflows and controls through template, code, and process updates

Your Knowledge and Experience

• Requires a bachelor’s degree in mathematics, statistics, actuarial science, computer science, or a related field
• Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
• Requires demonstrated understanding of basic regulatory concepts and filing support requirements under guidance
• Requires advanced experience and skillset in Microsoft Excel and SAS/SQL
• Requires strong communication and presentation skills
• Experience with data visualization tools such as Power BI or Tableau preferred
• Prior healthcare industry experience preferred
• Completed 3 actuarial exam courses toward ASA, Fellow of the Society of Actuaries or equivalent progress preferred

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

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 isa 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!

Our Values:

• 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 where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace modelis designed around intentional in-person interaction, collaboration,…