United States onlyHorizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This mid-level analyst role performs actuarial analysis for Horizon’s Medicaid business, including reserving and valuation, forecasting, experience analysis, and rate advocacy. This role applies actuarial techniques and data analysis to evaluate medical cost trends, utilization, program performance, while collaborating with actuarial leadership and cross functional partners.What You'll Do
Support forecast development and financial projections, reserves and analytics for the Medicaid lines of business.
Assess the impact of proposed state and federal legislative changes.
Perform experience analysis for Medicaid products, including medical cost, utilization, and trend components. Monitor emerging experience and identify drivers of variance from expected results.
Prepare actuarial exhibits, summaries, and documentation for internal leadership and external stakeholders.
Provide support for additional actuarial projects as requested.
Assist with Medicaid quarterly financial reporting, certifications, and responses to state inquiries.
Support analysis related to benefit changes, policy updates, and regulatory requirements.
Evaluate the financial impact of program changes, quality initiatives, and value‑based arrangements.
Ensure analyses align with CMS and state Medicaid guidelines.
Modeling & Data Analysis
Develop, maintain, and enhance actuarial models used for Medicaid analysis.
Validate data sources and ensure accuracy, consistency, and reasonableness of results.
Apply actuarial judgment in selecting assumptions and methodologies under guidance from senior staff.
Cross‑Functional Collaboration
Partner with Finance, Network, Clinical, and Operations teams to support Medicaid initiatives.
Communicate analytical results clearly to non‑actuarial stakeholders.
Respond to ad-hoc data requests and analytic questions related to Medicaid performance
What You Bring
Education/Experience:
Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or a related field.
2–4 years of actuarial or analytical experience.
Medicaid, or other government programs health insurance preferred.
Strong analytical, problem‑solving, quantitative skills, and written and verbal communication skills.
Proficiency in Excel and exposure to actuarial or data tools (e.g., SQL, SAS, R, Python, or similar.)
Working towards an ASA is highly preferred.
Additional licensing, certifications, registrations:
Associate of the Society of Actuaries (ASA) preferred.
Knowledge
Familiarity with capitation rate development and regulatory filings highly preferred.
Overachieving – demonstrated through a commitment to execution, accountability, results, and a curiosity mindset.
Requires expert knowledge of Excel.
Requires advanced proficiency with SAS or SQL.
Skills and Abilities:
Analytical thinking and attention to detail
Developing actuarial judgment
Ability to manage multiple priorities and deadlines
Collaboration and effective communication
Commitment to continuous learning and professional growth
Why Horizon?
At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you!
Salary Range:
$79,100 - $105,945This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement
Disclaimer:
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.
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