Principal Actuarial Healthcare Analyst

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

About Blue Cross and Blue Shield of Minnesota: At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

How Is This Role Important to Our Work?

This position applies broad actuarial principles and advanced analytics to diverse business questions and initiatives. The Actuarial Healthcare Principal will work independently and guide cross-functional teams to initiate, plan, and lead analysis from conceptual development to conclusion. The role involves collaborating with various departments, including finance, data & analytics, stars, risk adjustment, and other lever owners, to gather necessary data for modeling and analysis.

Your Responsibilities:

• Accountable for modeling the structure and outcomes of various initiatives

• Lead efforts with coworkers, internal business partners, and leadership to clarify requirements, analyze complex data, and produce and present meaningful and defensible results.

• Independently research, gather, analyze, and interpret medical data.

• Manage end-to-end modeling and solution development life cycle from requirements gathering, identification of data sources, model development and evaluation, to data processes and model implementation.

• Understand/interpret model results and make business practice recommendations to improve pricing, risk selection, and forecasting.

• Perform complex analysis of data, applying statistical methods when appropriate, and provide interpretation of outcomes.

• Lead teams to develop analytic approaches, measurement plans, data analysis, and report results on healthcare utilization, expenditures, outcomes, and benchmarks.

• Monitor and project provider and vendor performance relative to established contracts.

• Represent the division on corporate projects and may have leadership roles on these teams.

• Act as a resource and/or mentor for other members of the department and company on business issues and may be responsible for training and guidance of other employees.

• Formulate strategic recommendations and present findings to management and external clients.

• Stay up-to-date with industry trends, regulations, and best practices

Required Skills and Experiences:

• High school diploma (or equivalency) and legal authorization to work in the U.S.

• 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

• Experience in Health Insurance or medical data.

• Strong statistical analysis or actuarial work and network modeling.

• Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access.

• Demonstrated ability to design, evaluate, and interpret complex data sets.

• Excellent written and verbal communication skills, with the ability to interpret and communicate analytical information to both individuals and groups in a clear and concise manner.

• Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical, and clinical.

Preferred Skills and Experiences:

• Bachelor's degree in math, statistics, actuarial science, economics, or related field.

• Data querying and modeling experience in cloud platforms.

• Reporting experience with Power BI.

• Experience in advanced programming languages including but not limited to SQL, R, or SAS.

• Knowledge of managed care and healthcare claims.

Role Designation

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely.  Onsite is full-time onsite.

Compensation and Benefits

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance

• Life insurance

• 401k

• Paid Time Off (PTO)

• Volunteer Paid Time Off (VPTO)

• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.