Associate Fraud Analyst Jobs in Utah (NOW HIRING)

Job Description

Blue Cross NC is seeking a Principal Actuary to provide advanced actuarial analysis and technical support for complex rating and pricing, valuation, and financial forecasting work. This role applies deep knowledge of mathematics, probability, statistics, health insurance, and business principles to support key actuarial functions. The Principal Actuary partners with actuarial teams to ensure a coordinated approach across health programs and provides support to Network Management, Underwriting, and Sales and Marketing. This role may also include team leadership responsibilities, particularly for assigned projects.

What You'll Do

• Actively contributes to the success of the Actuarial Services team.

• Responsible for handling highly complex actuarial modeling.

• Leads and/or provides consultative support to assigned projects and is viewed as an expert in the field.

• Assists in Rating/Pricing

• Develop/Maintain rating models

• Perform Medical Trend analysis

• Support Administrative Expense factor development

• Conduct Experience Studies

• Conduct Rating Factor Studies

• Support Rate Filing development

• Assists in support for Financial Forecasting

• Works with FP&A to support development of Plan forecast for assigned segments

• Assists in support for Network Management

• Support evaluation of financial impacts of provider contract changes

• Assists in support for Underwriting (all segments)

• Provide ad hoc support for underwriting requests

• Assists in support for Sales and Marketing

• Provide support for new product development

• Provide support for new/existing product programs

• Continuing Education

• Responsible for maintaining continuing education requirements as set by the appropriate Actuarial governing body (i.e. Society of Actuaries)

• Is a participant in good standing in the Actuarial Development Program, if still pursuing the FSA designation

What You Bring

• Bachelor's degree or advanced degree (where required)

• Associate of the Society of Actuaries(ASA) and Member of the American Academy of Actuaries (MAAA)

• 5+ years of experience in related field

• In lieu of an ASA, alternate actuarial credentials may be considered.

• In lieu of 5 years of experience, may consider candidates who are Fellows of the Society of Actuaries (FSA).

What You'll Get

• The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.

• Work-life balance, flexibility, and the autonomy to do great work.

• Medical, dental, and vision coverage along with numerous health and wellness programs.

• Parental leave and support plus adoption and surrogacy assistance.

• Career development programs and tuition reimbursement for continued education.

• 401k match including an annual company contribution.

• Learn more

Where You'll Work

Our Hybrid Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that's flexible, connected, and future focused.

In a Hybrid-Flex role, you'll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you'll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$118,691.00 - $189,906.00

Skills

Actuarial Analysis, Actuarial Modeling, Actuarial Science, Actuarial Services, Benefits Analysis, Budgeting, Complex Project Management, Financial Analysis, Healthcare Management, Office Administration, People Management, Pharmacy, Provider Services, Requirements Management, Support Services, Underwriting Management

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.