Actuarial Analytics Director - Alternative Payment Models
Blue Cross and Blue Shield of Rhode Island
Actuarial Analytics Director - Alternative Payment Models
United States•5mo ago
FlexibleMedicare AdvantageHealth Other
Role Summary
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Director-level health actuarial role at a BCBS insurer in Providence, RI. Lead actuarial analytics for alternative payment models, provider contracting, risk adjustment projections and pharmacy rebate modeling. Own financial forecasting and translate actuarial outputs into finance and contracting decisions. Senior role requiring ASA or FSA and 7–10 years of health actuarial experience, including Medicare Advantage.
JOB DESCRIPTION SUMMARY
- Lead actuarial support for provider contracting and alternative payment models
- Model financial impacts, forecast shared savings/losses, and settlement outcomes
- Support risk adjustment projections and pharmacy rebate revenue forecasting
- Integrate actuarial outputs into finance models and ledger entries
- Director-level role based in Providence, RI with flexible onsite/hybrid/remote options
DOMAIN EXPERTISE
- Alternative funding arrangements in healthcare
- Medicare Advantage experience
- Provider contracting and feasibility analysis
- Risk adjustment projections and financial modeling
KEY REQUIREMENTS
- ASA or FSA designation required
- 7–10 years actuarial experience in health insurance
- Medicare Advantage background required
- Experience pricing and evaluating alternative funding arrangements in healthcare
- Bachelor’s degree in a quantitative field (required)
TECH STACK
- No tech stack specified
