Actuarial Analyst III

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This Senior Actuarial Analyst position resides within the Actuarial Department and plays a key role in supporting premium rate development and pricing strategies for the Large Group market. The role is responsible for analyzing and evaluating proposed benefit and cost-sharing changes, conducting pricing and financial impact studies, assessing the implications of state and federal legislative and regulatory changes, and supporting Mental Health Parity compliance reviews. Working closely with actuarial, finance, product, and regulatory teams, this position applies advanced actuarial methodologies, statistical analysis, and predictive modeling techniques to assess risk, evaluate financial outcomes, and support data-driven business decisions. The Senior Actuarial Analyst also contributes to a variety of strategic and operational initiatives, helping ensure pricing accuracy, regulatory compliance, and the long-term financial sustainability of the organization's products and programs. What You'll Do Assist in the development and maintenance of premium rates for the Individual and Small Group markets. Support the preparation, validation, and submission of premium rate filings to state and federal regulatory agencies. Analyze and evaluate proposed benefit design and cost-sharing changes to determine financial and actuarial impacts. Conduct pricing analyses, actuarial studies, and financial modeling to support product and rate development initiatives. Assess the impact of proposed state and federal legislative, regulatory, and healthcare reform changes on pricing and product strategy. Perform Mental Health Parity compliance reviews and support related regulatory reporting requirements. Conduct experience analyses and drill-down studies to identify emerging trends, utilization patterns, and key cost drivers. Develop ad hoc actuarial models and analytics to support strategic decision-making and business initiatives. Collaborate with Product, Finance, Underwriting, Regulatory, Compliance, and other business partners to evaluate assumptions and recommendations. Review and analyze data from multiple sources to support actuarial projections and risk assessments. Prepare reports, presentations, and recommendations for management, clearly communicating complex actuarial concepts and analytical findings. Support additional actuarial projects and initiatives as assigned by department leadership. Apply actuarial principles, statistical methods, and mathematical modeling techniques to evaluate risk and support sound business decisions. What You Bring Required Qualifications Bachelor's degree in Mathematics, Statistics, Actuarial Science, Economics, Finance, or a related quantitative field from an accredited college or university, or an equivalent combination of education and relevant experience. Minimum of four (4) years of actuarial, statistical, healthcare analytics, or related quantitative experience. Progress toward Associate of the Society of Actuaries (ASA) designation preferred. Experience supporting actuarial pricing, modeling, forecasting, or financial analysis initiatives. Preferred Qualifications Experience within the health insurance or managed care industry. Working knowledge of premium rate development, healthcare pricing, and actuarial methodologies. Familiarity with state and federal regulatory requirements related to health insurance products. Progress toward or attainment of ASA designation strongly preferred. Certifications Associate of the Society of Actuaries (ASA) preferred. Continued advancement through the Society of Actuaries examination process is highly desirable. Knowledge, Skills & Abilities Advanced proficiency in Microsoft Excel, including complex formulas, modeling, pivot tables, and data analysis. Experience with SAS, SQL, R, Python, or other statistical and analytical programming languages preferred. Strong understanding of actuarial principles, statistical methodologies, and quantitative analysis techniques. Ability to analyze large and complex data sets and translate findings into actionable business recommendations. Excellent analytical, mathematical, and problem-solving skills. Strong oral, written, and presentation communication skills with the ability to explain technical concepts to non-technical audiences. Demonstrated ability to exercise sound judgment and make data-driven recommendations. Strong attention to detail and commitment to accuracy. Ability to manage multiple projects and priorities in a fast-paced environment. Effective collaboration and relationship-building skills with cross-functional business partners. Top Skills for Success in This Role Actuarial Modeling & Pricing Analysis Healthcare Cost & Utilization Analytics Statistical Analysis & Forecasting Risk Assessment & Financial Modeling Regulatory & Rate Filing Support Mental Health Parity Analysis Data Visualization & Storytelling Advanced Excel & Analytical Tools SQL, SAS, R, or Python Proficiency Critical Thinking & Problem Solving Business Partnership & Collaboration Communication & Presentation Skills Why Horizon? At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you! Salary Range: $102,600 - $140,070 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer: Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process. About Us We are the leading health insurer in New Jersey, trusted by generations of families and businesses. We are dedicated to enriching the lives and health of our members and the New Jersey communities we serve, because we live and work here too. Our Mission We empower our members to achieve their best health. Our Vision We are New Jersey’s health solutions leader driving innovations that improve health care quality, affordability and member experience in the markets we serve.