Actuary

• Assisting in the determination of rates
• Analyzes, develops, and validates statistical data
• Support the Medicaid Pricing lead in developing rate impacts and assisting with projections

Actuarial Analyst I

• Research and develop new methods for insurance rating and loss reserving
• Prepare and coordinate analyses of rate and statistical filings for submission to regulatory and insurance agencies
• Serve as project leader for relatively complex projects and studies
• Perform GLM and other statistical techniques to enhance rating algorithms
• Provide filing support, product performance monitoring, and business insights
• Update and maintain loss cost modeling data sets

Actuarial Analyst IV, Pricing Design

• Lead quarterly and annual reserve analyses for multiple P&C lines of business.
• Evaluate reserve adequacy and analyze loss development trends.
• Prepare reserve recommendations and support statutory and management reporting.
• Collaborate with external actuaries on reserve studies, actuarial reviews, and reporting requirements.
• Partner with Claims, Underwriting, and Finance teams to identify emerging trends and assess business impacts.
• Maintain and enhance reserving models, methodologies, and supporting documentation.
• Train and mentor Financial Analysts on actuarial reserving techniques and best practices.
• Support audits, regulatory reviews, and actuarial reporting requirements.
• Identify opportunities for process improvement and automation within the reserving function.

Manager – Actuarial Reserving

• Lead complex actuarial and analytical initiatives, defining scope, work plans, and execution strategies.
• Advise leadership on analytical strategy, risk assessment, and project priorities.
• Oversee and take accountability for technical work produced by project teams.
• Develop and evaluate pricing, provider reimbursement, and benefit analyses.
• Interpret complex data and trends, translating insights into clear, actionable recommendations for leadership.
• Drive quality through peer review and strong documentation.
• Partner cross-functionally to provide ongoing and ad hoc actuarial support.
• Mentor and develop junior team members.

Senior Actuary

• Analyzes financial, statistical and mathematical data and performs actuarial calculations.
• May assist in the determination of pricing, reserves and/or cash flow projections.
• Assists in performing rate studies used in determining rate adequacy.
• Assists in actuarial research, experience studies, and statistical analyses and calculations.
• Provides support to senior analysts or actuaries as required.
• Retrieves and validates data for rate filings and actuarial models.
• Assists senior staff in the building of model enhancements and determines reasons for changes to calculated factors.
• Distributes established reports and responds to inquiries.
• Investigates trends and anomalies.
• Supports Enterprise Risk Management.
• Provides analytic support for corporate and departmental projects.

Actuarial Associate

• Completes projects and performs complex actuarial studies
• Obtains, verifies, analyzes and models data including risk reporting and forecasting
• Calculates monthly claims liability reserves
• Develops merit rating factors
• Prepares Department of Insurance annual statement exhibits

Actuarial Analyst II

• Use expertise in mathematics, statistics, health insurance, and business to support complex pricing, valuation, and financial forecasting.
• Lead analyses that shape pricing models, care management programs, and insurance product development.
• Turn complex data into clear, actionable recommendations that guide strategic decisions.
• Identify emerging risks and opportunities in a rapidly evolving industry.

Principal Actuary – ACA Pricing

• Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
• Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
• Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
• Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
• Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
• Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
• Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials.
• Develop measurement models for various cost savings initiatives across the company’s many strategic areas including, but not limited to clinical care management, alternative payment arrangements with providers, medical coding and policy adherence practices, and other emerging drivers of trend.

Principal Actuary, Cost of Care

• Lead client relationships that provide comprehensive H&W support and innovative solutions
• Lead H&W Workplace Consulting projects, mentor other associates and promote collaboration
• Lead the development and presentation of strategic recommendations to clients on an annual basis
• Build extensive knowledge of the client and their business and find opportunities to expand relationships to solve client problems
• Provide overall accountability to our clients for our analytical and actuarial deliverables
• Provide direction, support, and review of health and welfare program renewals/pricing, budgets, IBNP development, and other financial support
• Play a leadership role in efforts to expand our H&W client base through participation in RFPs, finalist meetings and the development of new offerings
• Develop and present webinars, and other marketing efforts, focused on actuarial insights of interest to current and prospective clients
• Collaborate with other senior leaders in the H&W practice to develop strategies to lead people development and client delivery
• Lead and mentor the team of H&W associates assigned to support your client team, as well as the general H&W practice
• Co-lead the development & maintenance of actuarial tools and standards required to support our clients’ ongoing H&W needs
• Interact with our clients’ Accounting and Finance Teams, as needed, to include meeting with clients’ outside auditors when requested

Vice President – Actuary, Health & Welfare

• Develops reporting structure, toolset and analytic strategy to support market and domain teams as well as pricing for programs and products.
• Supports the rating process by determining the need for and building actuarial model enhancements.
• Distributes established reports and responds to inquiries.
• Supports the investigation of trends and anomalies.
• Coordinate and independently develop BI content (reports, dashboards, scorecards, more complex analytic solutions) through the entire development life-cycle to provide data necessary to effectively make business decisions and measure goal attainment and overall performance.
• Share expertise with business areas to assist in understanding enterprise data content, definitions and usage and the available BI tools.
• Maintains robust knowledge of data assets and tools and supports development/maintenance of a formal Knowledge Base.
• Plans, implements, manages and/or contributes to projects that are moderate/high complexity.

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