Your Role
The Network and Trend Analytics (NTA) team supports the Network Management team with analytical and financial modeling for provider contracting and network development activities for Blue Shield of California. The Senior Manager, Actuary of NTA will report to the Senior Director of NTA. In this role you will be responsible for all provider contract analytical support including: hospital analysis, professional PPO fees schedules, IPA capitated modeling and other ad-hoc analytics. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Responsibilities
Your Work
In this role, you will:
- Have overall responsibility and accountability for 6 staff which will include reviewing staff work related to provider contracting support. This team will be supporting 1 of the BSC Network Management VPs and their associated provider contracting activities.
- Be responsible for developing and managing experience tracking reports, comparisons to Plan, tracking and quantifying variances and shares insights with the business unit and management
- Ensure timely and accurate delivery of all work products associated with their job responsibilities.
- Ensure team follows existing workflow procedures or policies and/or validates or developments new procedures and policies.
- Be responsible for understanding current and emerging regulatory and competitive developments, facilitating communication of these developments, and ensuring processes and procedures are consistent with changing regulations
- Be responsible for training and developing the staff
- Ensure team develops good relationships with the network management staff to help foster an environment of collaboration and problem solving
- Be responsible for strategic thinking and how the work connects to the big picture
- Be results driven, and have a competitive drive to best position BSC for long-term success
- Collaborate with other analytical areas within the organization to optimize the business outcomes
Qualifications
Your Knowledge and Experience
- Requires a bachelor's degree in actuarial science, mathematics, statistics, computer science or related field
- Requires 7 years prior relevant job experience
- Requires 2 years of management experience
- Requires an Associate of Society of Actuaries; Fellow of Society of Actuaries preferred
- Requires advanced knowledge and skills including technical or functional expertise, business acumen, financial analysis skills, risk management, delegation skills, critical thinking and decision-making skills
- Requires advanced knowledge and skills of management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation. Additionally, requires practical knowledge in leading and managing the execution of processes, projects, and tactics within an area
- Requires strong ability to communicate complex technical subjects to non-technical audiences
- Requires strong project and team management skills
- Requires strong problem-solving skills, self-motivation, detail orientation and critical thinking skills
- Prior Medicaid actuarial experience highly desired
Pay Range:
The pay range for this role is: $ 145970.00 to $ 218900.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
About the Team
Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
At Blue Shield of California, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above).Exceptions:
- Member-facing and approved out-of-state roles remain remote.
- Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
- For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.