Job Description

Your Work

In this role, you will:

• 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 evaluates 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

Your Knowledge and Experience

• 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

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