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Job Description Are you an experienced actuary looking to make a significant impact in the field of risk adjustment? Join our team as a Consulting Actuary specializing in ACA Risk Adjustment, where you'll play a crucial role in shaping our actuarial and analytical services. Your expertise will help drive pricing strategies and actuarial initiatives across various business segments, evaluate advanced care management models, and design and price innovative insurance products. This is your chance to proactively contribute to our company objectives by providing valuable actuarial insights and recommendations while addressing complex risks and opportunities. What You'll Do Lead complex actuarial projects from inception to completion, ensuring compliance, quality, and timely delivery. Proactively identify opportunities for process improvements, risk reduction, and enhanced value, aiming for profitable growth for Blue Cross NC customers. Meet and exceed financial targets while providing clear explanations of results and variances; serve as a financial steward. Effectively communicate with all organizational levels, including Divisional Leadership. Manage relationships with external partners including vendors, auditors, regulators, and healthcare providers, negotiating contracts and rates effectively. Establish and nurture strong business relationships with internal partners and provide exceptional support as a strategic advisor. Commit to ongoing professional development and maintain actuarial credentials through continuing education. What You Bring A Bachelor's degree or advanced degree as required. Membership in the American Academy of Actuaries. Fellowship of the Society of Actuaries preferred. Minimum of 7 years of relevant actuarial experience; candidates with 9 years of experience and an ASA are also welcomed. Bonus Points Extensive experience with ACA Risk Adjustment, particularly in HHS-HCC model methodology, risk score forecasting, and financial impact analysis - Highly Preferred. Proven expertise in ACA Risk Adjustment transfer forecasting and in communicating results to senior leadership - Highly Preferred. Strong understanding of diagnosis coding (ICD-10-CM), provider documentation practices, and their significance on risk adjustment outcomes. Advanced analytical skills to identify risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations. What You'll Get The opportunity to work at the forefront of health care delivery within a community-focused team. Work-life balance, flexibility, and the autonomy to excel in your role. Comprehensive medical, dental, and vision coverage along with a variety of health and wellness programs. Supportive parental leave policies and assistance with adoption and surrogacy. Access to career development programs and tuition reimbursement for continuing education. 401k match with annual company contributions. Salary Range At Blue Cross NC, we emphasize a competitive and equitable compensation package reflecting market standards. Our starting salaries are typically set near the mid-point of the specified range. Compensation decisions consider several factors including experience, specialized skills, and relevant certifications. Our base salary is complemented by a comprehensive Total Rewards package that includes an Annual Incentive Bonus based on corporate goals and individual performance. Annual corporate goal achievement and individual performance impact bonus eligibility. $143,616.00 - $229,786.00 Skills Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Affordable Care Act (ACA), Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance