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Actuarial Analyst, Experienced (Hybrid)

Company: Blue Shield of California
Location: Oakland
Posted on: November 19, 2022

Job Description:

Your RoleThe Medicare Risk Adjustment Analytics team is looking for an Experienced Actuarial Analyst. The Experienced Actuarial Analyst will report to the Manager of Medicare Risk Adjustment Analytics. In this role you will create and own various analytical projects that assist providers in accurately capturing the risk score of their population. Additional responsibilities include developing risk score projections and other related work to help the company achieve its financial and membership targets.Your WorkIn this role, you will:Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniquesConduct 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 analysisCoordinate, 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 strategiesPerform 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 efficienciesDirect, coordinate, and/or develop evaluation and financial reporting standards for internal and external reportsQuantify and project risk scores and revenue for the Medicare line of businessConduct complex actuarial analyses to assess risk scores, including performing root cause analysisCreate data-driven solutions for capturing risk and improving quality of care for our membersPerform vendor return on investment analyses to determine ongoing benefit and decision supportPerform other responsibilities as assigned

Keywords: Blue Shield of California, Oakland , Actuarial Analyst, Experienced (Hybrid), Professions , Oakland, California

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