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Principal Actuary - Medicare Advantage

Job description

Job Description

Blue Cross NC is seeking a Principal Actuary to join its Medicare Advantage Medical Economics team, serving as a market‑aligned thought partner to finance and health plan leadership. This role focuses on applying deep medical economics expertise and professional judgment to support market‑level decision‑making, ensuring leaders have a clear, credible understanding of medical cost performance and outlook. The ideal candidate brings strong analytical rigor, strategic perspective, and the ability to communicate complex concepts clearly to senior, non‑technical stakeholders. Leadership responsibilities may be assigned, particularly for designated projects.

What You’ll Do

  • Synthesize cost, utilization, mix, and unit cost dynamics to identify emerging risks and opportunities impacting market and segment financial performance

  • Translate complex medical cost dynamics into implications and recommendations that directly inform market strategy, pricing, and financial planning

  • Proactively identify, size, and frame cost management opportunities using rigorous, transparent analytics

  • Integrate insights across medical economics domains into a cohesive, market‑specific narrative

  • Responsible for maintaining continuing education requirements as set by the appropriate Actuarial governing body (i.e. Society of Actuaries)

  • Is a participant in good standing in the Actuarial Development Program, if still pursuing the FSA designation

What You Bring

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

  • Associate of the Society of Actuaries (ASA) and Member of the American Academy of Actuaries (MAAA)

  • 5+ years of experience in related field

  • In lieu of an ASA, alternate actuarial credentials may be considered.

  • In lieu of 5 years of experience, may consider candidates who are Fellows of the Society of Actuaries (FSA).

Bonus Points

  • Deep experience in medical cost trend development, forecasting, and decomposition for Medicare Advantage or closely related lines of business– Highly Preferred

  • Demonstrated ability to build and defend market‑specific trend assumptions that withstand executive and financial scrutiny – Highly Preferred

  • Expert-level knowledge of SQL and advanced Excel

  • Strong critical thinking and creative problem-solving skills.

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.
 

$118,691.00 - $189,906.00

Skills

Actuarial Analysis, Actuarial Modeling, Actuarial Science, Actuarial Services, Benefits Analysis, Budgeting, Complex Project Management, Financial Analysis, Healthcare Management, Office Administration, People Management, Pharmacy, Provider Services, Requirements Management, Support Services, Underwriting Management

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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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