Actuary

• Responsible for the overall management and technical oversight of an actuarial staff
• Involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity
• Oversee the preparation of rate filings for large group, small group, direct pay, or senior products
• Work with Underwriting and Rating, Sales and Product Management and Development to develop and implement appropriate rating strategies
• Provide advanced support for the claim reserve process
• Ensure that all new products are financially viable and stable

Director, Actuarial Services

• 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

• Define & diagnose a problem
• Outline data requirements for a study or analysis and devise potential solutions.
• Create studies, analyses, and presentation materials needed to appropriately inform decision makers.
• Make appropriate recommendations to management across teams within the actuarial department.

Associate Actuary

• Serve as a senior-level individual contributor within the Pharmacy Analytics team
• Support the organization’s pharmacy strategy through advanced actuarial and analytical expertise
• Perform complex actuarial analyses, generating actionable insights
• Inform strategic decision-making to drive business outcomes
• Collaborate closely with cross-functional stakeholders and other actuarial teams
• Provide guidance and oversight to junior team members

Consulting Actuary – Pharmacy

• Performs actuarial research, experience studies, and statistical analyses and calculations.
• Calculates premiums and reserves of new and existing plans of insurance.
• Provides support to senior analysts or actuaries as required.
• Retrieves and validates data for rate filings and actuarial models.
• Builds model enhancements and determines reasons for changes to calculated factors.
• Analyzes impacts of changes to product lines and segments.
• Communicates filing status to internal stakeholders and transmits rate filings to regulatory agencies (NCDOI, CMS).
• Retrieves and validates data for monthly reports and for UCL and ALR calculation.
• Supports valuation by executing ALR model and verifying results.
• Researches to support ALR assumption studies and UCL estimates.
• Distributes established reports and responds to inquiries.
• Investigates trends and anomalies.
• Executes control activities to support Enterprise Risk Management.
• Provides analytic support for corporate and departmental projects.
• Is a participant in good standing in the Actuarial Development Program

Actuarial Analyst

• Performs qualitative and quantitative analysis of data to support development of rating plans and pricing for programs and products.
• Evaluates moderately complex trend analysis.
• Supports the rating process by determining the need for and building actuarial model enhancements.
• Determines reasons for changes in calculated factors and communicates changes to internal stakeholders.
• Reviews and observe appropriateness of actuarial formulae.
• Transmits rate filings to regulatory agencies (NCDOI, CMS).
• Supports valuation by modifying and executing the ALR model.
• Distributes established reports and responds to inquiries.
• Investigates trends and anomalies.
• Supports resolution of control exceptions and maintains control documentation.
• Participates in requirements gathering for and serves as delegate or backup for corporate projects.

Senior Actuarial Analyst

• Work in a fast-paced, innovative, and change-oriented work environment
• Build a strong network of peers and mentors
• Attend on-site technical and professional development classes
• Participate in sponsored community service events
• Utilize advanced Excel techniques and programming
• Work with large data sets
• Gain exposure to actuarial software, including GGY AXIS, MG-ALFA, and PolySystems

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