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Horizon Blue Cross Blue Shield of New Jersey

Horizon Blue Cross Blue Shield of New Jersey

Actuarial Analyst II Cost Of Care

Actuarial Analyst II Cost Of Care

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Job Details
""
Uploaded On
December 17, 2023
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Location
Newark, NJ - Hybrid
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Remote?
No
Salary
$
75
k-$
101
k
Glassdoor Ratings
""
Recommend to a Friend
50%
""
Overall Score
3.3 / 5

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Job Summary:

This is a mid-level analyst position within the Actuarial department. This area evaluates Initiatives to assess impact to Horizon. The incumbent will evaluate vendor proposals and programs to support HNS vendor strategy, in addition to support Medical Policy and the Reimbursement Policy Committee regarding financial impacts of policy changes. Develop mathematical modeling techniques and statistical concepts to determine probability and assess risks.
  • Perform or support trend analysis
  • Perform quarterly Forecasting:  Evaluating our current claim and premium experience so as to project our future financial position
  • Monthly IBNR calculations:  Estimating our outstanding claim reserve liabilities at the end of each month
  • Develop pricing models and support pricing requests which may include rate filings, benefit adjustment factors, fee schedule analysis, new product pricing, etc
  • Monthly P&L financial reconciliations and frequent liaisons with the Finance team
  • Present reports, explaining their implications to managers and directors, and advising on risk limitation
  • Communicating with internal clients and carrying out relationship with financial directors and stakeholders
  • Experience studies and drill downs to figure out why certain things are occurring. 
  • Ad-hoc modeling and projects.

Education/Experience:

  • Requires a Bachelors degree, preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university, or equivalent work experience
  • Requires 2+ years of actuarial and/or statistics experience or attainment of Associate level in the Society of Actuaries (ASA)
  • ASA candidate a plus


Knowledge:

  • Requires working knowledge of Excel
  • Prefers working knowledge of Access or other database application
  • Prefers experience with SAS or other programming language
  • Prefers knowledge of data analysis and Actuarial principles
  • Requires good oral and written communication skills
  • Requires strong analytical thinking
  • Requires strong mathematical skill and statistical analysis abilities
  •  Requires good judgment and problem solving skills


Skills and Abilities:

  • Requires good oral and written communication skills
  • Requires strong analytical thinking
  • Requires strong mathematical skill and statistical analysis abilities
  • Requires good judgment and problem solving skills


 

Salary Range:

$75,300 - $100,800

​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.  This range has been created in good faith based on information known to Horizon at the time of posting.  Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

  • Comprehensive health benefits (Medical/Dental/Vision)

  • Retirement Plans

  • Generous PTO

  • Incentive Plans

  • Wellness Programs

  • Paid Volunteer Time Off

  • Tuition Reimbursement

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.  Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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Working at 

Horizon Blue Cross Blue Shield of New Jersey

Horizon Blue Cross Blue Shield of New Jersey, a leading health insurance provider, has been at the forefront of serving the health needs of New Jersey residents for over 90 years. As a not-for-profit health service corporation, Horizon BCBSNJ is committed to delivering quality health care products, services, and information. Their dedication to improving health outcomes, combined with a deep understanding of the local community, offers actuaries a unique opportunity to work on impactful projects, drive health innovations, and contribute to a healthier New Jersey.