Actuarial Analyst, Senior

Blue Shield of CaliforniaOakland, CA
16h

About The Position

Your Role The Actuarial Provider Strategies team supports the budget setting, program design, and operations of Blue Shield of California’s value-based care (VBC) payment models, which includes Accountable Care Organization (ACO) and other innovative, alternative payment models. The Actuarial Analyst - Senior will report to the Principal of Actuarial Provider Strategies. In this role you will have responsibility evaluating the performance of Blue Shield of California’s value-based care models, including cost, utilization and quality assessment. Responsibilities 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 Support the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up. Perform data exploration using a combination of statistical programming languages (including, but not limited, R, Python, SQL, SAS) and deploy actuarial and statistical techniques to evaluate the value-based care models with clear outcome and deliverable Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports Support production of the final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience’s understanding for all of Blue Shield of California’s value-based care models. This can be done via presentations, memos, external publications, or all the above. Research clinical and financial outcomes from others like value-based care programs in the industry Work with other colleagues from different areas to solve business problems; this may involve presenting either verbally or in written format to key stakeholders or leadership Qualifications Your Knowledge and Experience Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience Requires at least 3 years of professional actuarial experience May have an ASA designation or has completed the majority of the courses to complete the ASA designation Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL Requires strong communication and presentation skills Requires strong ability to communicate complex technical subjects to non-technical audiences Desires some level of experience in Visualization tool like Tableau and Machine Learning basics Desires a curious mindset and eagerness to learn Prior healthcare industry experience preferred

Requirements

  • Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
  • Requires at least 3 years of professional actuarial experience
  • May have an ASA designation or has completed the majority of the courses to complete the ASA designation
  • Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL
  • Requires strong communication and presentation skills
  • Requires strong ability to communicate complex technical subjects to non-technical audiences

Nice To Haves

  • Desires some level of experience in Visualization tool like Tableau and Machine Learning basics
  • Desires a curious mindset and eagerness to learn
  • Prior healthcare industry experience preferred

Responsibilities

  • Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques
  • Support the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up.
  • Perform data exploration using a combination of statistical programming languages (including, but not limited, R, Python, SQL, SAS) and deploy actuarial and statistical techniques to evaluate the value-based care models with clear outcome and deliverable
  • Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
  • Support production of the final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience’s understanding for all of Blue Shield of California’s value-based care models. This can be done via presentations, memos, external publications, or all the above.
  • Research clinical and financial outcomes from others like value-based care programs in the industry
  • Work with other colleagues from different areas to solve business problems; this may involve presenting either verbally or in written format to key stakeholders or leadership
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