Actuarial Analyst, Experienced Job at Blue Shield of California, Oakland, CA

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  • Blue Shield of California
  • Oakland, CA

Job Description

Your Role

 

The Network and Trend Analytics team drives the development of an affordable provider network through data analytics and expertise. The Experienced Actuarial Analyst will report to the Senior Principal and will perform actuarial analysis primarily supporting the Behavioral Health provider network.

Your Work

 

In this role, you will:

  • Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques
  • 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
  • Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies
  • Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
  • Understand and accurately track the unit cost trend, support database upgrade
  • Generate reports and analysis from unit cost tracking database, respond to requests from inside and outside of the team

Your Knowledge and Experience

 

  • Requires a bachelors degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
  • Requires at least 2 years of professional actuarial experience
  • Requires proficiency in Excel and Access
  • Prefers proficiency in VBA and SAS

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