Principal Actuary, Cost of Care

This is a fully remote position, open to applicants in Alabama, +22 more states.

📋 Description

• Execute intricate actuarial or analytical projects efficiently, ensuring compliance and high standards of quality.

• Offer strategic guidance to enhance processes, minimize risks, and fulfill both departmental and enterprise goals.

• Support profitable expansion while enhancing value, quality, and accessibility for Blue Cross NC customers.

• Meet financial objectives for segments and provide explanations for results and discrepancies.

• Serve as a financial custodian for the organization.

• Engage in communication across all organizational tiers and divisions, including Divisional Leadership.

• Oversee external collaborations with vendors, auditors, regulators, and healthcare providers.

• Negotiate contracts and/or rates effectively.

• Build and sustain robust relationships with internal stakeholders while acting as a strategic consultant.

• Conduct performance evaluations for current and proposed Cost of Care initiatives.

• Create measurement models aimed at cost-saving initiatives across clinical care management, alternative payment arrangements, medical coding, policy adherence, and emerging trend drivers.

• Perform pricing and actuarial strategy, evaluate care management models, conduct competitive benchmarking, and assess economic value.

⛳️ Requirements

• Bachelor’s degree or a higher degree in a relevant field.

• ASA designation is mandatory; candidates who are sitting for exams may be considered based on additional experience.

• FSA is preferred.

• Over 5 years of pertinent actuarial experience; related experience may be taken into account.

• Proficient in SQL-based data queries and data management.

• Familiarity with data visualization tools such as Power BI and Tableau.

• Experience in developing and delivering external, client-facing materials and reports.

• Compliance with continuing education requirements necessary for the job function and maintenance of actuarial credentials.

🏝️ Benefits

• Work-life balance, flexibility, and independence.

• Comprehensive medical, dental, and vision coverage.

• Health and wellness initiatives.

• Parental leave and support services.

• Assistance for adoption and surrogacy.

• Opportunities for career development.

• Tuition reimbursement for ongoing education.

• 401k matching along with an annual company contribution.

• Annual performance-based incentive bonus.

• Paid Time Off (PTO).