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Blue Cross NC

Principal Actuary - ACA Pricing

Posted Yesterday
Be an Early Applicant
In-Office or Remote
24 Locations
119K-190K Annually
Senior level
In-Office or Remote
24 Locations
119K-190K Annually
Senior level
Lead complex actuarial pricing, valuation, and forecasting for ACA products. Develop and maintain rating models, perform medical trend and experience studies, support rate filings, underwriting, network management, provider contract evaluation, sales/marketing, and new product development. Serve as subject matter expert and advisor while maintaining actuarial credentials and continuing education.
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Job Description

As a Principal Actuary in ACA Pricing, you’ll use your expertise in mathematics, statistics, health insurance, and business to support complex pricing, valuation, and financial forecasting. You’ll lead analyses that shape pricing models, care management programs, and insurance product development—helping us deliver high-quality, cost-effective care to the communities we serve.
You’ll serve as a trusted advisor, turning complex data into clear, actionable recommendations that guide strategic decisions. By identifying emerging risks and opportunities, you’ll help us stay agile in a rapidly evolving industry.
If you're passionate about using actuarial expertise to make a meaningful impact in healthcare, we’d love to have you on our team.

What You’ll Do

  • Contribute to the success of the Actuarial Services team through strong partnership and technical expertise.

  • Lead highly complex actuarial modeling to support key business decisions.

  • Lead or provide consultative support on assigned projects and serve as a trusted subject matter expert.

  • Support rating and pricing activities for assigned work.

  • Develop and maintain rating models used to inform actuarial analysis.

  • Perform medical trend analyses to evaluate cost patterns and emerging impacts.

  • Support the development of administrative expense factors.

  • Conduct experience studies to assess performance and support decision-making.

  • Conduct rating factor studies to evaluate assumptions and pricing inputs.

  • Support the development of rate filings.

  • Contribute to financial forecasting efforts across assigned areas.

  • Partner with FP&A to support plan forecasting for assigned segments.

  • Provide actuarial support to Network Management initiatives.

  • Evaluate the financial impact of provider contract changes.

  • Support underwriting activities across all segments.

  • Provide ad hoc actuarial support for underwriting requests.

  • Support Sales and Marketing initiatives with actuarial insights.

  • Contribute to new product development efforts.

  • Support new and existing product programs.

  • Stay current through ongoing professional development and continuing education.

  • Maintain continuing education requirements set by the appropriate actuarial governing body, such as the Society of Actuaries.

  • If applicable, remain an active participant in good standing in the Actuarial Development Program while pursuing the FSA designation.

What You Bring

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

  • 5+ years of experience in related field.

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

  • 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).

Bonus Points 

  • Experience in ACA Pricing 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

  • Learn more 

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

_____________________________________________________________________
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: [email protected].

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