Consulting Actuary

As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments, evaluating advanced care management models, conducting competitive benchmarking analyses, and designing and pricing sophisticated insurance products. You will support company objectives by providing reliable, actionable actuarial insights and recommendations, proactively identifying and addressing complex risks and opportunities. This position requires adaptability to the evolving landscape of the industry, ensuring our actuarial practices remain at the forefront of innovation and excellence. 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
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; Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials
Bachelor's degree or advanced degree (where required)

• Member of the American Academy of Actuaries
• Fellow of the Society of Actuaries
• 7 years of relevant actuarial experience, related experience may be considered.
• In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.

Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score forecasting, and financial impact analysis - Highly Preferred
P roven expertise in ACA Risk Adjustment transfer forecasting and explanation of results to senior leadership - Highly Preferred
Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their impact on risk adjustment outcomes.
Advanced analytical skills to identify risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.

• Medical, dental, and vision coverage along with numerous health and wellness programs.
• Career development programs and tuition reimbursement for continued education.
• Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

$Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Affordable Care Act (ACA), Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance _____________________________________________________________________
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