Principal Actuarial Data Systems Analyst

Join a team where technology meets strategy. As a Principal Actuarial Data Systems Analyst, you will play a crucial role in delivering technical data support and innovative solutions for Actuarial financial data systems and Marts. You’ll partner closely with actuaries, finance, medical economics, and data teams to analyze claims experience, medical cost trends, utilization patterns, IBNR reserving inputs, and predictive models that support business and actuarial decision-making. You will lead and coordinate development work to deliver solutions to support business areas/functions for implementation of accurate financial data.

What You’ll Do

• Develop complex decision support data solutions, data extracts, reports, data marts, and/or analysis. Responsible for the entire development life cycle.

• You’ll partner closely with actuarial reserving teams to develop insights across the entire claims’ lifecycle, from service occurrence and claim submission through adjudication, payment, runout, and reserve development.

• Develop and maintain datasets supporting IBNR reserve calculations, completion factors, lag analyses, and actuarial modeling.

• Partner with healthcare actuarial reserving teams to support monthly and quarterly reserve analyses, financial forecasts, and experience studies

• Perform data quality assessments and reconcile claim, membership, and financial data across multiple systems.

• Analyze medical and pharmacy claims data to identify utilization trends, cost drivers, emerging risks, and opportunities for operational improvement.

• Performs monthly data refreshes, validations, automations, and quality assurance checks to support executive financial reporting.

• Manages the Maintenance and optimization of the Actuarial Systems Data Marts.

• Serve as the lead for multiple application areas, including data definitions, usage and file structure, technical structure of the code and the business rules, and structure of requirements that govern the functionality of the system.

• Independently analyze business challenges or opportunities; develop recommendations and solutions, implement those solutions, and provide communications on the associated actions, business impacts, and results.

• Lead in ensuring Financial granular detail data is appropriately auditable, snapshotted, and stored for quarterly and year end audits.

• Provide analytical support for departmental, divisional, and corporate projects as needed to accomplish their business goals and to ensure the business needs are met.

• Coordinate work and provide direction, assistance and training to peers and junior staff members.

• Provide detailed configuration expertise to customers and business partners. This includes verbal, written, and electronic communication, and delivering presentations when needed.

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

• 8+ years of experience in related field.

• In lieu of degree, 10+ years of experience in related field.

Bonus Points

• 5+ years of SQL Development/Analysis experience. (Highly preferred)

• 5+ years of healthcare analytics, actuarial analytics, payer analytics, or strong medical claims data functional/life cycle knowledge (Highly preferred).

• Facets experience a plus.

• Experience supporting actuarial trend analysis.

• Experience with Snowflake, AWS cloud environments., Application Implementation, Best Practices Development, Business Process Improvements, Business Requirements, Business Requirements Analysis, Information Technology (IT) Projects, Information Technology Project Management, Requirements Gathering, Requirements Management, Technical Architecture

• 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 (https://careers.bluecrossnc.com/global/en/benefits)

Where You’ll Work

Our Hybrid Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that’s flexible, connected, and future focused.

In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

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

It’s an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we’re leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care - in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at HR.Staffing@bcbsnc.com .

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming