Managing Actuary - Risk Adjustment

About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?

We are looking for a Managing Actuary to apply broad actuarial principles to develop solutions for risk adjustments, primarily in Medicare, Medicaid and ACA. The Managing Actuary is responsible for guiding and motivating the actuarial team. This is a high visibility role that will directly impact our organization’s goals!  

A Day in the Life:

• Research and Analysis: Conduct in-depth research, analysis, and interpretation of actuarial and statistical data specifically related to risk adjustments. Identify issues requiring investigation, determine affected areas, estimate impacts, and lead resolution efforts.

• Issue Identification and Resolution: Identify and research issues related to Medicare risk adjustments, determine the areas affected, estimate the impact, and lead the resolution process.

• Training and Supervision: Provide training and work direction to Analysts, ensuring they are well-versed in risk adjustment methodologies and practices.

• Model Design: Collaborate with other departments to design mathematical models that predict the impact of proposed changes on risk adjustments.

• Product and Process Development: Analyze claims, revenue, and other relevant data to suggest amendments or develop new products and processes that maintain product viability and financial soundness.

• Project Leadership: Represent the division on corporate projects, potentially taking on leadership roles within these teams to ensure risk adjustment considerations are addressed.

• Data Management: Independently manage the retrieval and analysis of data for multiple tasks or projects related to risk adjustments, with minimal management involvement. This may include directing other staff members.

Nice to Have:

• Bachelor's degree.

• Experience with risk adjustment heavily preferred.

• Experience with Medicare

• If you do not have Medicare experience, we are also looking for candidates with Medicaid and ACA experience.

Required Skills and Experiences:

• 6+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

• ASA or above.

• Strong Delegation skills.

• Strong oral and written communication skills.

• Excellent PC skills.

• Knowledge of data retrieval languages.

• Knowledge of BCBSMs databases or industry knowledge.

Role DesignationHybrid

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely.  Onsite is full-time onsite.

Compensation and Benefits

$115,000.00 - $155,300.00 - $195,600.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance

• Life insurance

• 401k

• Paid Time Off (PTO)

• Volunteer Paid Time Off (VPTO)

• And more

To discover more about what we have to offer, please review our benefits page.

Make a Difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected].

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.