Consulting Actuary - Medicare Risk Adjustment

Job Description

As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through data-driven insights and strategic actuarial expertise. You'll lead initiatives that directly impact patient outcomes and business performance-whether it's designing innovative insurance products, optimizing pricing strategies, or evaluating advanced care management models.

Your work will support key organizational goals by delivering clear, consistent, and actionable analysis that informs executive decision-making. You'll also conduct competitive benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape.

This role is ideal for a forward-thinking actuary who thrives in a dynamic environment and is passionate about using their skills to improve healthcare affordability, accessibility, and quality.

What You'll Do

• 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

What You Bring

Bonus Points

What You'll Get

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus

$117,200.00 - $222,500.00

Skills

Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance