Responsible for pricing, risk management, reserving, forecasting, trend setting and actuarial administration including conducting analysis, monitoring, evaluating, and reporting of the effectiveness of rating formula and participating in the development of new products.
Provides Actuarial department with pricing support, calculating reserves, risk assessment/analysis, data reporting, financial forecasting/projections, creating filings and/or performing financial and risk analysis in changes to provider contracts to help meet company goals of providing low-cost healthcare and meeting earnings objectives.
May perform a combination of the following depending on discipline/dept.
Understands the core principles of decision analytics, with knowledge of the analytic tools and techniques that are used to acquire and analyze data for reporting and decision making used for decision analytics.
Can understand, update, and run programs that applies to decision analytic techniques.
Has gained a basic understanding of claim, premium, membership and/or risk score assignment data.
Learns various actuarial techniques and procedures to conduct analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis.
Compiles and categorizes data, documenting and verifying the factors used in computations such as those used in evaluating loss and expense reserves, preparing rate filings, schedules of statistics, premiums, benefits, member risk data and score submissions and establishing rating and pricing levels.
Produces timely various standard analytic reports for internal and/or external use. Other duties as assigned.
Requires BS degree in mathematics, statistics, computer science or related discipline and/or equivalent business experience.
Typically, has completed 1 to 2 courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation.
No previous professional actuarial experience required but typically has obtained broad theoretical job knowledge through advanced education.
Blue Shield Of California