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Hiring Remotely in Exchange, IN, USA
In-Office or Remote
117K-187K Annually
Mid level
Healthtech
The Role
Support actuarial and financial functions for pharmacy benefit programs by analyzing claims, utilization, cost trends, and financial performance. Build statistical and actuarial models for pricing, forecasting, and reserve adequacy. Extract and analyze data from databases, prepare regulatory reports, and participate in projects and departmental initiatives.
Summary Generated by Built In

Pay Range:

$116,900.00 - $187,100.00 

Please email [email protected] if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

 

At BCBSRI, our greatest resource is our people. 

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.


We recognize that to do your best work, you have to be your best self. 
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.


Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. 

We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

 

Why this job matters:

The Actuary will support a broad range of actuarial and financial functions related to BCBSRI's pharmacy benefit programs. This highly visible role requires extensive analysis of pharmacy claims experience, drug utilization, cost trends, and financial performance to support pricing, forecasting, product strategy, and pharmacy benefit management initiatives.

What you will do:

  • Monitor, analyze, and report on the effectiveness of the existing rating formula.  Perform financial forecasting and trend analysis.

  • Develop statistical and actuarial models to assist in the analysis of rate and reserve adequacy.  Evaluate corporate loss reserves. 

  • Design and write computer programs to extract data from various databases.  Extract and analyze claims, enrollment, and general health insurance data.

  • Prepare regulatory reporting requirements.

  • Participate in department initiatives and projects.

  • Perform other duties as assigned.

What you need to succeed:

  • Bachelor’s degree in Mathematics, Economics, or related field, or an equivalent combination of education and experience

  • Three to five years actuarial experience

  • ASA Society of Actuaries designation

  • Ability to interpret and perform financial forecasting, statistical modeling, and trend analysis

  • Advanced analytical skills, with the ability to interpret and synthesize complex data sets

  • Good business acumen and political savvy

  • Knowledge of business process improvement techniques and strategies

  • Excellent verbal and written communications skills

  • Negotiation skills

  • Presentation skills

  • Decision-making skills

  • Good problem solving skills

  • Ability to interface with employees at all levels

  • Ability to effectively navigate ambiguous situations with limited direction

  • Excellent organizational skills and ability to successfully prioritize multiple tasks

  • Ability to handle multiple priorities/projects

The extras:

  • Experience in the health insurance industry

     

    Location:
    BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

    • In-office: onsite 5 days per week
    • Hybrid: onsite 2-4 days per week
    • Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
       

    Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

    The law requires an employer to post notices describing the Federal laws. Please visit  www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.

    Skills Required

    • Bachelor's degree in Mathematics, Economics, or related field (or equivalent combination of education and experience)
    • Three to five years actuarial experience
    • ASA Society of Actuaries designation
    • Ability to interpret and perform financial forecasting, statistical modeling, and trend analysis
    • Advanced analytical skills and ability to interpret and synthesize complex data sets
    • Design and write computer programs to extract and analyze claims, enrollment, and health insurance data
    • Prepare regulatory reporting requirements
    • Good business acumen and political savvy
    • Knowledge of business process improvement techniques and strategies
    • Excellent verbal and written communications skills
    • Negotiation skills
    • Presentation skills
    • Decision-making and problem-solving skills
    • Ability to interface with employees at all levels and navigate ambiguous situations with limited direction
    • Excellent organizational skills and ability to prioritize and handle multiple projects
    • Experience in the health insurance industry
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    The Company
    HQ: Providence, RI
    828 Employees

    What We Do

    Blue Cross & Blue Shield of Rhode Island (bcbsri.com) is a non-profit, community-focused health plan founded in 1939 to help Rhode Islanders finance their healthcare needs. Today, that’s still a big part of what we’re all about. We are committed to improving the health and peace of mind of our members by facilitating their access to affordable, high-quality healthcare. Our goal is to improve the quality of life of our customers and of the people of Rhode Island by improving their health for generations to come. We are an independent licensee of the Blue Cross and Blue Shield Association.

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