Job Description

JOB DESCRIPTION
Your Role
The Cost of Healthcare Trend team measures medical and pharmacy cost of healthcare trends \xe2\x80\x93 both retrospective and prospective \xe2\x80\x93 for all lines of business. The Actuarial Analyst, Experienced, Cost of Healthcare Trend will report to the Senior Manager, Cost of Healthcare Trend. In this role you will work closely with the team and with colleagues from various backgrounds and roles within the company 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
• Analyze health care claims experience, cost of care savings, and trend
• Prepare management reports supporting enterprise communications related to cost of care and trend performance
• Support the development of dashboards, scorecards, and other reporting tools using data visualization tools such as Excel, Tableau, and/or Power BI
• Drive continuous improvement in existing Trend models

QUALIFICATIONS
Your Knowledge and Experience

• Requires a bachelor\xe2\x80\x99s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Requires at least 2 years of professional actuarial experience
• Preferred: at least three courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation
• Preferred: Prior healthcare industry experience
• Advanced experience in Microsoft Excel and SAS/SQL
• Strong communication, presentation, and creative problem-solving skills
  

Pay Range: The pay range for this role is: $ 79750.00 to $ 111650.00 for California. Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate\'s experience, location (California, Bay area, or outside California), and current employee salaries for similar role
ABOUT US
At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We\'re excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Area\'s top companies in volunteering & giving, and one of the world\'s most ethical companies. Here at Blue Shield of California, we\'re striving to make a positive change across our industry and the communities we live in , Join us!

ABOUT THE TEAM
Blue Shield of California\xe2\x80\x99s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen. Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area\xe2\x80\x99s top companies in volunteering & giving, and one of the world\xe2\x80\x99s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in \xe2\x80\x93 join us! Our Values:

• Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we\'re going to do and by acknowledging and correcting where we fall short.
• Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Physical Requirements:



Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.





Equal Employment Opportunity:



External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.


COVID-19 Vaccination Policy: From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date. The definition of "up to date with your COVID-19 vaccine" is when you have received all doses in the primary series and one booster when eligible. If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.