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Role Summary

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HIGHLIGHTS

Senior health actuarial role at Blue Cross NC focused on ACA Risk Adjustment. You will lead pricing strategies, evaluate care management models, design insurance products, and manage external partnerships. Requires an FSA (or ASA with more experience) and deep expertise in ACA risk adjustment methodology, risk score forecasting, and financial impact analysis. The role offers flexibility, strong benefits, and a competitive salary.

JOB DESCRIPTION SUMMARY

  • Lead ACA pricing, risk adjustment, and product strategies
  • Forecast risk scores, analyze HHS-HCC model methodology
  • Manage external vendor and regulator partnerships
  • Provide strategic actuarial insights to senior leadership
  • FSA required (ASA considered with 9+ years experience)

DOMAIN EXPERTISE

  • ACA Risk Adjustment (HHS-HCC model methodology)
  • Risk score forecasting and financial impact analysis
  • Diagnosis coding (ICD-10-CM) and provider documentation practices
  • Complex care management evaluation

KEY REQUIREMENTS

  • Fellow of the Society of Actuaries (FSA)
  • 7+ years of relevant actuarial experience (9+ years for ASA)
  • Deep expertise in ACA Risk Adjustment, HHS-HCC model
  • Experience with risk score forecasting and financial impact analysis

TECH STACK

  • No tech stack specified
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Role Summary

Loading...

HIGHLIGHTS

Senior health actuarial role at Blue Cross NC focused on ACA Risk Adjustment. You will lead pricing strategies, evaluate care management models, design insurance products, and manage external partnerships. Requires an FSA (or ASA with more experience) and deep expertise in ACA risk adjustment methodology, risk score forecasting, and financial impact analysis. The role offers flexibility, strong benefits, and a competitive salary.

JOB DESCRIPTION SUMMARY

  • Lead ACA pricing, risk adjustment, and product strategies
  • Forecast risk scores, analyze HHS-HCC model methodology
  • Manage external vendor and regulator partnerships
  • Provide strategic actuarial insights to senior leadership
  • FSA required (ASA considered with 9+ years experience)

DOMAIN EXPERTISE

  • ACA Risk Adjustment (HHS-HCC model methodology)
  • Risk score forecasting and financial impact analysis
  • Diagnosis coding (ICD-10-CM) and provider documentation practices
  • Complex care management evaluation

KEY REQUIREMENTS

  • Fellow of the Society of Actuaries (FSA)
  • 7+ years of relevant actuarial experience (9+ years for ASA)
  • Deep expertise in ACA Risk Adjustment, HHS-HCC model
  • Experience with risk score forecasting and financial impact analysis

TECH STACK

  • No tech stack specified

Job Overview

Salary
$144k - $230k
Years of Experience
7+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a Director-level FSA (or ASA+9) with deep ACA Risk Adjustment expertise, including HHS-HCC model methodology and risk score forecasting, who enjoys strategic leadership and external partnership management in a health plan environment.

FSA

Benefits

Bonus EligibleAnnual Bonus401(k) PlanHealth InsuranceDental InsuranceVision InsurancePaid Parental LeaveTuition Reimbursement
Shortlist Forming
Closing Soon
25d
25 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Job Overview

Salary
$144k - $230k
Years of Experience
7+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a Director-level FSA (or ASA+9) with deep ACA Risk Adjustment expertise, including HHS-HCC model methodology and risk score forecasting, who enjoys strategic leadership and external partnership management in a health plan environment.

FSA

Benefits

Bonus EligibleAnnual Bonus401(k) PlanHealth InsuranceDental InsuranceVision InsurancePaid Parental LeaveTuition Reimbursement
Shortlist Forming
Closing Soon
25d
25 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Consulting Actuary - ACA Risk Adjustment

Blue Cross NC

Health/Insurer/Director Level
Blue Cross NC

Consulting Actuary - ACA Risk Adjustment

Blue Cross NC
United States•3w ago
FlexibleACA Exchange

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