• Compile, clean, and validate healthcare claims and enrollment data for use in actuarial analyses. • Assist with medical cost and utilization analyses, including trend calculations, PMPM reporting, and benchmark comparisons. • Support rate development and rate review work by preparing data exhibits, trend summaries, and documentation under the direction of senior staff. • Maintain and update actuarial models and exhibits under the direction of senior staff. • Write and maintain SQL queries and data scripts to extract and manipulate data from healthcare claims databases. • Prepare exhibits, tables, and supporting documentation for client deliverables and internal reports. • Research CMS program guidelines, rate notices, and policy updates to support team knowledge. • Participate in internal training sessions and support knowledge sharing across the actuarial team. • Actively pursue actuarial exam progress with support from the company's study program.

• Lead our group pricing function for our Employee Benefits Life, Absence and Disability $4b block of business. • Play a key role in growing profits through strategic pricing decisions, industry insights, superior analytics and innovative solutions. • Develop and execute pricing philosophy, strategy and tactical actions to achieve long term business objectives. • Oversee reinsurance for our group benefit products to facilitate and maintain appropriate levels of risk retention. • Support product development in partnership with other key stakeholder groups.

Role Description The Principal Actuary delivers a broad range of actuarial or analytical work for the company, such as: - Conducting pricing and actuarial strategy for a business segment - Evaluating advanced care management models - Performing competitive benchmarking analysis - Conducting economic value evaluation of cost containment initiatives They support the company strategy by providing sound, consistent, and actionable actuarial analysis and recommendations, and can identify and react to nuanced risks and opportunities. This particular role will focus on performance evaluations for both existing initiatives within the Cost of Care portfolio and newly proposed initiatives across several different subject areas including clinical, pharmacy, network, payment integrity, value-based care, and more. What You’ll Do: - 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 Qualifications - Bachelor's degree or advanced degree in related field - ASA designation (FSA preferred); exam takers may be considered based on other experience - 5+ years of relevant actuarial experience; related experience may be considered Requirements - SQL-based data queries and data management - Experience with data visualization applications such as Power-BI and Tableau - Experience creating and presenting external, client-facing materials and reports Benefits - The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community - Work-life balance, flexibility, and the autonomy to do great work - Medical, dental, and vision coverage along with numerous health and wellness programs - Parental leave and support plus adoption and surrogacy assistance - Career development programs and tuition reimbursement for continued education - 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. 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. *Based on annual corporate goal achievement and individual performance. $118,691.00 - $189,906.00 Job Alert Fraud We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on our careers page . If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com .

Role Description Join VillageCare as a Full-Time Senior Financial Data Analyst in the dynamic healthcare sector and play a pivotal role in shaping the financial strategies that impact our community. This position offers work-from-home flexibility, allowing you to balance your professional responsibilities with your personal life while contributing to meaningful healthcare solutions. Based in New York, NY, you will be part of a dedicated team that values excellence and customer-centricity in its mission to provide outstanding healthcare services. Your analytical expertise will drive decision-making in an energetic and forward-thinking environment. As a Senior Financial Data Analyst at VillageCare, you will: - Develop, document, and maintain reports and analytics that empower leadership with key insights to drive financial success. - Ensure the accuracy and timeliness of routine and ad hoc reports. - Collaborate closely with both internal and external customers to guarantee successful report roll-ups and high customer satisfaction. - Utilize advanced tools such as SQL, Tableau, and RedShift to create customized dashboards for the Finance department. - Work with the IT team to automate reports for efficient metric monitoring. - Support the monthly close process and conduct claim reserve analysis. - Create member economics reports to aid strategic decision-making. - Lead medical claims reinsurance reporting and support the preparation of provider group financial statements. - Ensure compliance with regulatory reporting requirements. Qualifications - Minimum 5 years of relevant professional work experience. - Experience working in an actuarial function with a focus on building the claims reserve, updating claims triangles, and IBNR estimation. - Ability to perform complex data analysis and report/dashboard development in a healthcare setting. - Excellent technical skills (MS Excel, SQL, Tableau, Access, Python, etc.). - Capacity to multi-task at a high detail-oriented level. - Strong communication skills (verbal, written, presentation, interpersonal). - Strong analytical and logical skills paired with strong attention to detail. - Bachelor's degree in Healthcare, Finance, or a relevant field or equivalent years of experience required. Requirements - Must reside in NY, NJ, or CT. Benefits - Competitive salary range of $87,647.11 to $98,603.00. - Work-from-home flexibility. Company Description VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health, and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.