Actuarial Analyst, Consultant

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!


Job Summary
  • Responsible for pricing, risk management, reserving, forecasting, trend setting and actuarial administration including conducting analysis, monitoring, evaluating, and reporting of the effectiveness of rating formula and participating in the development of new products.
  • Provides Actuarial department with pricing support, calculating reserves, risk assessment/analysis, data reporting, financial forecasting/projections, creating filings and/or performing financial and risk analysis in changes to provider contracts to help meet company goals of providing low-cost healthcare and meeting earnings objectives.
  • May perform a combination of the following depending on discipline/dept.: Understands the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques.
  • Has knowledge of the requisite analytic tools and techniques and can manage and own an advance analytic based project from end to end.
  • Can direct the work of lower level analysts and be accountable for solving business problems.
  • Can explain advance analytic projects to audiences outside of their job function. Acts as the subject matter expert in the data areas of claim, premium, membership, and/or risk score assignment.
  • Conduct and develops analysis, assess risk and population risk score sand 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.
  • Coordinates, prepares, perform and audits 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.
  • Maintains documentation or actuarial analysis and models as well as provides consultation and clarification on actuarial models and other Actuarial work products.
  • Directs, coordinates, and/or develops evaluation and financial reporting standards for internal and external reports. Other duties as assigned.


Knowledge and Experience
  • Requires college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience.
  • Typically has obtained their ASA designation and has completed 1 to 2 courses toward their FSA designation.
  • Requires deep knowledge of job area obtained through professional experience and advanced education.
  • Typically viewed as a specialist within the Actuarial job area and may have basic knowledge of project management.
  • Typically, requires a minimum of 6 to 7 years of professional actuarial experience.
  • Possesses high proficiency in applied statistics skills, such as distributions, statistical testing, regression, etc.
  • Can program in SQL, SAS and/or Tableau, and experience with common data science toolkits such as R and Python.
  • Has a business level, functional exposure to three or more machine learning algorithms such as random forest, decision trees, clustering, generalized linear models, principle component analysis etc.
  • Able to provide evidence of prior simple machine learning model builds.
  • Able to evaluate machine learning model results and perform analysis of feature.

Physical Requirements

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
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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.EEO Policy