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

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
Proven 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

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

Consulting Actuary – ACA Risk Adjustment

Key skills