Job Description
A Consulting Actuary delivers a broad range of actuarial or analytical work for the company, such as conducting pricing and actuarial strategy for a business segment, evaluating advanced care management models, performing competitive benchmarking analysis, and conducting economic value evaluation of cost of care programs. They support the company strategy by providing sound, consistent, and actionable actuarial analysis and recommendations, and can identify and react to nuanced risks and opportunities. This particular role will focus on performance evaluations for both existing initiatives within the Cost of Care portfolio and newly proposed initiatives across several different subject areas including clinical, pharmacy, network, payment integrity, value-based care, and more.General Description
Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work.
Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers.
Achieve segment financial targets and provide concise explanations of results and variances to expectations, act as a financial steward for the company.
Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates.
Develop and maintain strong business relationships with internal partners through business expertise and exceptional support, act as a strategic advisor.
Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials.
Specific Description
Analysis of actual savings versus expected savings generated by various Cost of Care initiatives within the overall BCBSNC Cost of Care portfolio.
Validation of savings projections for new potential initiatives to be added to our Cost of Care portfolio spanning various disciplines including clinical interventions (utilization mgmt. and specific condition-focused programs), network strategy, alternative payment models, payment integrity policies, pharmacy management, social determinants of health impacts, etc.
Development and delivery of Cost of Care savings reports including follow-up responses regarding results (i.e. material changes in results, anomalies, impact to financial projections, etc.
Hiring Requirements
Bachelor's degree or advanced degree in related field
ASA designation (FSA preferred); exam takers may be considered based on other experience.
5+ years of relevant actuarial experience, related experience may be considered.
Preferred Skills
SQL-based data queries and data management
Experience with data visualization applications such as Power-BI and Tableau
Experience creating and presenting external, client-facing materials and reports.
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
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