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Healthtech
Manage small programs or phases of larger programs, coordinating resources, schedules, budgets, vendors, contracts, reporting, evaluations, and process improvements. Monitor program performance, document outcomes, prepare presentations and reports, and implement changes to achieve program objectives. The role requires collaboration across stakeholders and oversight of program administration and operations.
Healthtech
Leads actuarial financial data systems and marts, developing data solutions, extracts, reports, analyses, automations, validations, and executive reporting support. Manages data mart maintenance, audits, business requirements, technical specifications, user acceptance testing, and system implementations. Provides technical leadership, coordinates vendors and departments, trains junior staff, and advises project teams on data architecture, business rules, configuration, and financial data quality.
Top Skills:
AWSFacetsSnowflakeSQL
Healthtech
Lead complex actuarial projects focused on ACA risk adjustment, pricing, forecasting, and competitive benchmarking. Provide strategic actuarial guidance, manage vendor and regulator relationships, achieve financial targets, and communicate results to senior leadership while maintaining actuarial credentials.
Top Skills:
Aca Risk AdjustmentHhs-Hcc ModelIcd-10-Cm
Healthtech
Provides advanced analytical support for ACA risk adjustment, including model implementation, RAF validation, forecasting, reporting, reconciliation, and discrepancy analysis. Uses SQL and Python to analyze healthcare data, improve recurring processes, develop controls, and support regulatory and financial activities. Partners with actuarial, regulatory, finance, operational, provider, and vendor stakeholders; presents findings and recommendations; maintains analytical applications; and mentors less experienced employees.
Top Skills:
PythonSQL
Healthtech
Support actuarial teams with rating, pricing, valuation, and forecasting for health programs. Perform data retrieval/validation, experience studies, statistical analyses, ALR/UCL calculations, rate filings, and reporting. Collaborate with underwriting, network, finance, and other stakeholders and participate in the Actuarial Development Program.
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Healthtech
Lead short-, medium-, and long-term cash flow forecasting; analyze liquidity trends, risks, and opportunities; communicate actionable insights to senior management and the Board; partner with Finance, Treasury, Actuarial, Investments, and business leaders; and optimize excess cash according to investment policies.
Top Skills:
KyribaExcelPower BIPower QueryTableau
Healthtech
Provides audit and risk advisory services across subsidiaries, focusing on financial, strategic, and entity-level risks and controls. Performs walkthroughs, control testing, process analysis, audits, deficiency assessments, remediation validation, and advisory engagements. Uses COSO and related frameworks to strengthen governance and internal controls, develops mitigation strategies, documents findings, trains management, and prepares audit reports.
Top Skills:
AicpaCosoIcfrExcelMicrosoft PowerpointMicrosoft VisioMicrosoft WordOptro/AuditboardPcaobSox/Mar
Healthtech
Prepare and review financial statements, coordinate month-end close and reporting, analyze complex accounting information, resolve GAAP/SAP issues, maintain controls, support audits, and recommend process improvements. Provide technical guidance, coach colleagues, conduct due diligence, evaluate deal structures, and participate in cross-functional finance projects. The role requires collaboration with auditors, other Blue Cross plans, and the BCBSA.
Top Skills:
Microsoft DynamicsOracleSAPWorkday
Healthtech
Supports commercial reserving through actuarial research, experience studies, statistical analysis, premium and reserve calculations, valuation, rate filings, reporting, and healthcare analytics. The role validates data, enhances actuarial models, investigates trends, supports regulatory submissions and enterprise risk management, and provides analytical support to internal business partners. Candidates need a degree, actuarial experience, and at least three exams toward the ASA designation, with alternatives considered for additional experience or exams.
Healthtech
Provides legal counsel for pharmacy benefit management and State Health Plan operations. Responsibilities include interpreting PBM contracts, advising on state and federal health plan regulations, supporting vendor oversight, privacy and data governance, audits, public records requests, claims and appeals, regulatory inquiries, and implementation initiatives. The role also monitors legal developments, trains stakeholders, and helps manage contractual, compliance, and operational risks.
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