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Added 2 days ago
HCC Coding Manager
IKS Health
Virtual
The Coding Manager reports to the Director of Coding Services and leads the day-to-day delivery of remote coding services for an assigned portfolio of Value-Based Care (VBC) clients. This…
Added 2 days ago
Manager, VBC Analytics - Capitation
CVS Health
Hartford, CT
Added 3 days ago
Manager, VBC Analytics - Capitation
CVS Shared Services Resources LLC
Remote, United States
Added 4 days ago
AP
Account Manager Enterprise Partnerships, Alabama & Mississippi Gulf Coast
Aledade PBC
Remote, United States
- $90,000 to $100,000 USD / year
As our Account Manager, you will be the ultimate strategic partner, business coach, and advocate for the medical practices in your portfolio. You are the day-to-day anchor of these…
Added 4 days ago
AP
Account Manager Enterprise Partnerships, Utah/Montana
Aledade PBC
Remote, United States
- $90,000 to $100,000 USD / year
As our Account Manager, you will be the ultimate strategic partner, business coach, and advocate for the medical practices in your portfolio. You are the day-to-day anchor of these…
Added 4 days ago
AP
Account Manager Enterprise Partnerships, NE & Central Pennsylvania
Aledade PBC
Remote, United States
- $90,000 to $100,000 USD / year
As our Account Manager, you will be the ultimate strategic partner, business coach, and advocate for the medical practices in your portfolio. You are the day-to-day anchor of these…
Added 4 days ago
AP
Account Manager Enterprise Partnerships, Greater Philadelphia Area
Aledade PBC
Remote, United States
- $90,000 to $100,000 USD / year
As our Account Manager, you will be the ultimate strategic partner, business coach, and advocate for the medical practices in your portfolio. You are the day-to-day anchor of these…
Added 5 days ago
SH
Lead Analyst, Healthcare Economics
Strive Health
Denver, CO
- $99,000 to $124,000 USD / year
…economics expertise, and business acumen. Reporting to the Sr. Manager, Healthcare Economics, you’ll work closely with stakeholders across clinical operations, finance, actuarial, and data…
Added 9 days ago
Population Health and VBC Program Manager
ADELANTE HEALTHCARE INC
Phoenix, AZ
The Population Health and Value-Based Care Manager is responsible for developing and implementing strategies to optimize health outcomes for diverse populations served by Adelante…
Added 9 days ago
PH
Director, Clinical Performance
Pearl Health
Remote, United States
- $165,000 to $200,000 USD / year
…for a portfolio of Pearl's client ACOs, combining hands-on analytics with clinician-to-clinician credibility to drive measurable performance improvement - working hand-in-hand with our…
Added 10 days ago
Actuarial Analyst II
The Harbor Health Team Inc
Remote, United States
…the intersection of traditional actuarial science and data analytics, this role offers the unique opportunity to work cross-functionally across our ACA Individual & Family Plans, Large…
Added 13 days ago
R
Senior Product Manager, HIE, AI Suspecting, and Care Gap Management
Reveleer
Remote, United States
- $140,000 to $160,000 USD / year
Reveleer is hiring a Senior Product Manager to lead product for both the HIE & AI Suspecting and Care Gap Manager domains within our Clinical Intelligence Suite of VBC solutions. The HIE…
Added 16 days ago
Manager, Value-Based Care
Premier Community Healthcare Grp.
Dade City, FL
Premier Community HealthCare Group is seeking a strategic, mission-driven Manager, Value-Based Care (VBC) to lead value-based performance across our managed-care and Accountable Care…
Added 18 days ago
AC
Staff Healthcare Analyst
Abby Care
San Francisco, CA
- $180,000 to $220,000 USD / year
Reporting to the Senior Manager of Data & Analytics, you will set the strategy and standards for how we measure risk, cost, and outcomes, and build the analytical models and studies that…
Added 19 days ago
AP
Program Specialist, CMMI Programs
Aledade PBC
Remote, United States
- $80,000 to $92,000 USD / year
Reporting directly to the Center for Medicare and Medicaid Innovation (CMMI) Program Manager, the Program Specialist will be a pivotal contributor to the operational excellence and…
Added 20 days ago
Director, Product Innovation
1upHealth
Remote, United States
…compliance and investing significantly in the payer data and analytics space. We're looking for a seasoned healthcare product leader to identify the biggest opportunities in that market and…
Added 22 days ago
Manager VBC Analytics
CVS Health
Remote, United States
…improving outcomes for the communities we serve. We are seeking a Manager, Medicaid Value-Based Care (VBC) Analytics to support value-based care partnerships across Aetna's Medicaid…
Added 24 days ago
Manager, Quality & Value-Based Care
Together Women's Health, LLC
Grosse Pointe, MI
The Manager of Quality Performance & Reporting is responsible for leading the organization’s MIPS reporting, quality improvement initiatives, and payer quality incentive programs across…
Added 26 days ago
Product Manager, Product Management
Wellvana Integration Partners, LLC
TN
The Product Manager reports to the Director of Product Management and Innovation. This role serves as the product owner and is the primary liaison between internal stakeholders, end users,…
Added 27 days ago
AH
Senior Product Manager
Arbital Health
Remote, United States
- $185,000 to $215,000 USD / year
5+ years of experience in product management, actuarial, analytics, or a similar role, with at least 3 years as a product manager on B2B data, analytics, or financial software products
Added 27 days ago
Senior Technical Product Manager, Data Integrations/Pipeline
U.S. Renal Care, Inc.
Plano, TX
The Senior Technical Product Manager for Data Integrations /Pipeline is to focus on providing rich data to our
Added 27 days ago
TT
Manager, Business Development- Payor Partnerships
TRC Total Renal Care Inc
United States
- $95,000 to $135,000 USD / year
Manager, Payor Partnerships – Value-Based Care Business Development
Added 27 days ago
Senior Consultant, Health Care
COPE Health Solutions
New York City, NY
Project scopes may focus on clinical redesign, financial modeling, network development, strategic planning, data analytics and/or organizational transformation. This position requires an…
Added 27 days ago
Manager, Health Care Consulting
COPE Health Solutions
Downtown Los Angeles, CA
The Manager, Health Care Consulting will work closely with firm leadership to manage and support consulting engagements and business development opportunities. The Manager must be able to…
Added 28 days ago
AO
Senior Vice President, Payor Growth
Atlas Oncology Partners
Remote, United States
- $225,000 to $290,000 USD / year
- 10+ years healthcare experience, including contracting, med economics / analytics, strategy, and / or partnerships

BSC

Actuarial Analyst, Experienced

Long Beach, CA, United States
CA, United States

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Job details

Experience: Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
Posting language: English
Posted: Oct 5, 2026

Original job description

Your Role

The Pay for Value team supports the program design, budget setting, and operations of Blue Shield of California’s value-based care (VBC) models, including Accountable Care Organization (ACO), Primary Care, Virtual Care, and other innovative programs. The Actuarial Analyst, Experienced will report to the Actuarial Director of the Pay for Value team. In this role you will support reporting and analytical work across various programs, collaborating with colleagues from diverse backgrounds and roles within the company.

Your Work

In this role, you will:

Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
Own data pulls, quality checks, and documentation across claims, premium, membership, and risk score sources
Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
Translate results into clear summaries for more senior actuaries and business partners
Improve workflows and controls through template, code, and process updates
Support VBC program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development
Collaborate with internal teams and cross-functional partners to support VBC program development and ensure alignment with BSC healthcare affordability and quality objectives
Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses
Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships

Your Knowledge and Experience

Requires a bachelor’s degree in mathematics, statistics, actuarial science, computer science, or a related field
Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
Requires demonstrated understanding of basic regulatory concepts and filing support requirements under guidance
Requires advanced experience and skillset in Microsoft Excel and SQL
Requires curiosity and willingness to adopt new technologies, including AI-enabled tools, to assist with analytical work, while exercising sound professional judgment
Requires strong communication and presentation skills
Experience with data visualization tools such as Power BI or Tableau preferred
Prior healthcare industry experience preferred
Completed 3 actuarial exam courses toward ASA, Fellow of the Society of Actuaries or equivalent progress preferred

Hybrid This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

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More about this job

Skills

Primary care
Reporting
Work analytically
Forecasting
Statistical quality control
Documentation
ESRI What if?
Statistics
Actuarial science
Computer science
Microsoft Excel
SQL
Communication skills
Presentation skills
Data visualization
Microsoft Power BI
Tableau

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