Note: The job is a remote job and is open to candidates in USA. Horizon Blue Cross Blue Shield of New Jersey empowers members to achieve their best health and has been a leader in health solutions for over 90 years. The Actuarial Analyst II role involves supporting actuarial and data analytics for risk-adjusted business, analyzing risk scores, financial impacts, and performance metrics to guide risk adjustment strategy and reporting.
Responsibilities
- Perform or support actuarial analytics on risk adjustable lines of business, including ACA, Medicare Advantage, and Medicaid
- Perform or support CMS-HCC and HHS-HCC risk score projections, including RATP, MA MYRA/FYRA accruals, and RADV financial impacts
- Perform or support data analytics and reporting to inform risk adjustment operations, strategy, submissions, and vendor performance
- Perform or support financial metrics pertaining to risk adjustment performance, including but not limited to intervention ROI
- Collect and analyze data to use for financial and utilization reporting and monitoring
- Support pricing and forecast efforts, including ACA pricing and MA Bid submissions
Skills
- Bachelors degree is required, preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university
- Requires 2+ years of actuarial and/or statistics experience or attainment of Associate level in the Society of Actuaries (ASA)
- Requires working knowledge of Excel
- Requires good oral and written communication skills
- Requires strong analytical thinking
- Requires strong mathematical skill and statistical analysis abilities
- Requires good judgment and problem solving skills
- ASA candidate a plus
- Prefers experience with SAS or other programming language
- Prefers knowledge of data analysis and Actuarial principles
Benefits
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Company Overview