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Consulting Actuary - Part D

Roles & Responsibilities

  • Bachelor's degree or advanced degree (where required)
  • Member of the American Academy of Actuaries
  • Fellow of the Society of Actuaries (FSA) or Associate of the Society of Actuaries (ASA) with at least 9 years of relevant actuarial experience
  • 7+ years of relevant actuarial experience (related experience may be considered)

Requirements:

  • Lead and deliver complex actuarial or analytical projects on time, ensuring compliance and high-quality output
  • Provide proactive, strategic leadership to improve processes, reduce risks, and support profitable growth and value for Blue Cross NC customers
  • Achieve segment financial targets and clearly explain results and variances; act as a financial steward for the organization
  • Manage external partnerships with vendors, auditors, regulators, and health care providers, and negotiate contracts and/or rates; build strong internal relationships and act as a strategic advisor

Job description

Job Description

As a Consulting Actuary – Part D, you will play a critical role in delivering a wide range of actuarial and analytical services for our organization. Your responsibilities will include developing pricing strategies and actuarial solutions for specific business segments, evaluating advanced care management models, conducting competitive benchmarking analyses, and designing as well as pricing complex insurance products. You will support the company's strategic objectives by providing reliable, actionable actuarial insights and recommendations, while adeptly identifying and responding to nuanced risks and opportunities. In this role, you will demonstrate flexibility and adaptability within a dynamic and evolving industry environment.

What You’ll Do

  • 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.

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • Member of the American Academy of Actuaries

  • Fellow of the Society of Actuaries

  • 7 years of relevant actuarial experience, related experience may be considered.

  • In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.

Bonus Points

  • Experience in Medicare Part D pricing with a deep understanding of Part D financial drivers strongly preferred

  • Proficiency with drug trend modeling and loss‑of‑exclusivity (patent loss) forecasting

  • Strong formulary strategy and analytics skills, including formulary composition, tiering strategy, and formulary impact modeling

What You’ll Get

  • The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community.

  • Work-life balance, flexibility, and the autonomy to do great work   

  • Medical, dental, and vision coverage along with numerous health and wellness programs.

  • Parental leave and support plus adoption and surrogacy assistance   

  • Career development programs and tuition reimbursement for continued education  

  • 401k match including an annual company contribution

  • Learn more   

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.
 

$143,616.00 - $229,786.00

Skills

Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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