Actuarial Analyst, Principal

Job Description

The Actuarial Provider Strategies team is responsible for partnering with the Blue Shield Health Solutions teams on developing, scaling and executing provider-focused strategies that promote high quality, affordable health care. The Network‑Growth Partnership role will report to the Vice President of Actuarial Provider Strategies and is focused on converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute.

As a member of the Actuarial Provider Strategies team, you will work closely with the Network team to ensure that pricing and financial objectives are translated into executable plans for providers. You will collaborate with General Managers, the Pricing Team, and other functions to prioritize requests and develop data‑driven recommendations.

• Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute.
• Create value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy.
• Create value for the Network team by organizing and focusing the various requests from the General Managers and Pricing Team into a prioritized, workable list.
• Be required to have strong influencing skills across multiple functions within Blue Shield with a drive towards consensus, and an ability to handle shifting priorities and ambiguity with agility.
• Lead, coordinate and/or develop strategic, market and competitive analysis.
• Conduct 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 evaluate actuarial risk related analysis.
• Coordinate, 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 strategies.

• Requires a bachelor's degree in mathematics, statistics, computer science or equivalent business experience.
• Requires an ASA.
• Requires at least 8 years of professional actuarial experience.
• Requires at least 1 year of pricing experience, with experience in multiple lines of business desired.
• Requires at least 2 years of experience in actuarial provider contracting analysis.

Office Environment – roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level:
Sedentary, frequency most of work day.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.