[Hiring] Actuarial Analyst III @Horizon Blue Cross Blue Shield of New Jersey

Role Description

This senior level actuary analyst position resides within the Actuarial Department and focuses on Government Programs (Medicare, PDP, DSNP, Medicaid) Trend Forecasting. The role is responsible for supporting the evaluation of proposed benefit and cost-sharing changes, conducting pricing studies, assessing the impact of state and federal legislative changes, and contributing to various actuarial initiatives. The position applies actuarial principles, mathematical modeling techniques, and statistical analysis to evaluate risk and support sound business and pricing decisions.

Additionally, this role serves as a key AI integration partner responsible for driving the adoption and effective use of AI across actuarial trend work. The individual will apply expertise in trend development and identification of key cost and utilization drivers to shape high-value use cases, deliver small-scale AI solutions, advance innovation, monitor adoption outcomes, and escalate misalignment or stalled progress.

What You'll Do

• Assist in the development of forecasted trends.
• Evaluate proposed benefit and cost-sharing changes and assess their financial impact.
• Conduct pricing analyses and studies for product lines of business.
• Analyze the impact of proposed state and federal legislative and regulatory changes.
• Conduct experience studies and detailed analyses to identify cost drivers, utilization patterns, and emerging trends.
• Proactively identifies, shapes, and documents AI use cases in partnership with business unit stakeholders, ensuring proposed opportunities are grounded in business need, aligned to the business unit's strategy.
• Accountable for AI adoption and utilization within the business unit.
• Support additional actuarial projects and initiatives as assigned.
• Collaborate with internal stakeholders and incorporate feedback from cross-functional business partners.
• Prepare reports and presentations that communicate findings, recommendations, and key insights to management.
• Complete ad hoc modeling, forecasting, and analytical projects as needed.

Qualifications

• Bachelor's degree required, preferably in Actuarial Science, Mathematics, Statistics, Economics, Data Science, or a related quantitative field.
• Minimum of 4 years of actuarial, statistical, healthcare analytics, or related experience required.
• Progress toward Associate of the Society of Actuaries (ASA) designation is highly preferred.
• Health insurance, healthcare, or managed care experience is preferred.
• Knowledge of artificial intelligence concepts, tools, and platforms at a practical working level, including generative AI, large language models, prompt engineering, AI assistants, and low-code/no-code AI development tools.
• ASA highly preferred.

Requirements

• Advanced proficiency in Microsoft Excel required.
• Experience with SAS, SQL, R, Python, or similar analytical/programming tools preferred.
• Working knowledge of actuarial concepts, data analysis, and statistical methodologies preferred.
• Strong analytical, mathematical, and statistical problem-solving skills.
• Excellent verbal and written communication skills, with the ability to present complex information clearly and effectively.
• Demonstrated critical thinking, sound judgment, and attention to detail.
• Ability to work independently while managing multiple priorities in a deadline-driven environment.
• Requires strong mathematical skill and statistical analysis abilities.
• Requires good judgment and problem-solving skills.

Benefits

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

Salary Range

$87,300 - $119,070