Actuarial Analyst, Experienced

Your Role

The Medi-Cal team supports Blue Shield of California Promise Health Plan with their Medicaid operations. The Actuarial Analyst, Experienced will report to the Actuarial Senior Principal of the Medi-Cal team. In this role you will support the core actuarial work needed to support the Medi-Cal line of business, including monthly financial close, plan projections and accruals, savings initiatives, capitation rate reviews, and trend analysis.
 

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, review pricing and trends, assess changes in benefit designs, review reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis
• Coordinate, prepare, perform and audit actuarial analyses to assist the review 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
• Build and maintain financial and actuarial models in Microsoft Excel using healthcare claims data to provide insights and support business decisions
• Support initiatives to improve processes and propose creative ideas that enhance experience of stakeholders and team
• Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses