Blue Cross NCBN

Consulting Actuary - Medicare Risk Adjustment

Blue Cross NC is a not-for-profit health insurance provider that aims to make healthcare easier and more affordable for over 4.3 million members in North Carolina.

Blue Cross NC

Employee count: 5000+

Salary: 117k-223k USD

United States only

Job Description

As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through data-driven insights and strategic actuarial expertise. You’ll lead initiatives that directly impact patient outcomes and business performance—whether it’s designing innovative insurance products, optimizing pricing strategies, or evaluating advanced care management models.

Your work will support key organizational goals by delivering clear, consistent, and actionable analysis that informs executive decision-making. You’ll also conduct competitive benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape.

This role is ideal for a forward-thinking actuary who thrives in a dynamic environment and is passionate about using their skills to improve healthcare affordability, accessibility, and quality.

What You’ll Do

  • Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
  • Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
  • Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
  • Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
  • Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
  • Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
  • Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials

What You Bring

  • Bachelor's degree or advanced degree (where required)
  • Member of the American Academy of Actuaries
  • Fellow of the Society of Actuaries
  • 7 years of relevant actuarial experience, related experience may be considered.
  • In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.

Bonus Points

  • Experience in Medicare Advantage Risk Adjustment highly preferred

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 

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.

$117,200.00 - $222,500.00

Skills

Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 117k-223k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Blue Cross NC

Learn more about Blue Cross NC and their company culture.

View company profile

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has been committed to making health care easier, more affordable, and more accessible for all since its establishment in 1933. As a not-for-profit company, Blue Cross NC serves more than 4.3 million members and works diligently to meet the health insurance needs of individuals, families, and businesses throughout North Carolina. The company offers various health insurance plans, including individual and family plans, Medicare options, and coverage for employer groups.

Blue Cross NC believes in a community-first approach and has generously invested over $200 million into local initiatives focusing on improving health outcomes, fighting food insecurity, and supporting education, among other causes. With a dedicated workforce of more than 5,000 employees, Blue Cross NC prioritizes member service and satisfaction by offering tailored resources and support to navigate the complexities of health insurance. The company’s commitment to not just insuring, but truly caring for its members, reinforces its mission to improve health care for all North Carolinians.

Claim this profileBlue Cross NC logoBN

Blue Cross NC

View company profile

Similar remote jobs

Here are other jobs you might want to apply for.

View all remote jobs

22 remote jobs at Blue Cross NC

Explore the variety of open remote roles at Blue Cross NC, offering flexible work options across multiple disciplines and skill levels.

View all jobs at Blue Cross NC
Blue Cross NC logoBN
United States only

Principal Salesforce Admin

Blue Cross NC

Employee count: 5000+

Salary: 91k-164k USD

Blue Cross NC logoBN
United States only

Director, Payment Integrity Strategy and Operations

Blue Cross NC

Employee count: 5000+

Salary: 132k-251k USD

Blue Cross NC logoBN
United States only

Sr. Regional Liaison

Blue Cross NC

Employee count: 5000+

Salary: 69k-124k USD

Blue Cross NC logoBN
United States only

Intake Specialist

Blue Cross NC

Employee count: 5000+

Salary: 42k-54k USD

Blue Cross NC logoBN
United States only

Sr BI Analyst

Blue Cross NC

Employee count: 5000+

Salary: 84k-152k USD

Blue Cross NC logoBN
United States only

Principal BI Analyst

Blue Cross NC

Employee count: 5000+

Salary: 106k-192k USD

Remote companies like Blue Cross NC

Find your next opportunity by exploring profiles of companies that are similar to Blue Cross NC. Compare culture, benefits, and job openings on Himalayas.

View all companies

Find your dream job

Sign up now and join over 85,000 remote workers who receive personalized job alerts, curated job matches, and more for free!

Sign up
Himalayas profile for an example user named Frankie Sullivan
Blue Cross NC hiring Consulting Actuary - Medicare Risk Adjustment • Remote (Work from Home) | Himalayas