Claims Representative Salary at California Casualty Management Co BETA

Your Role The ASO and Specialty Pricing team supports rate filing, discount submission, and financial analysis for Blue Shield of California in the ASO and Specialty space. The Actuarial Analyst – Experienced role will report to the Senior Manager of Pricing for Select & Specialty. In this role you will be responsible for extracting and analyzing data to support UDS submissions and other large data sets as well as other actuarial analysis and reporting. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis Coordinate, prepare, perform and audit actuarial

Your Role The Risk Adjustment Analytics and Reporting team is looking for a Senior Actuarial Analyst. The Senior Actuarial Analyst will report to the Senior Manager of Risk Adjustment Analytics and Reporting. In this role you will help provide analytical support for various prospective programs across multiple lines of business, primarily concentrating on Medi-Cal. This involves working closely with risk adjustment models, member targeting and tracking, financial forecasting, and various other analytical requests. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive and predictive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis

Your Role The Individual Pricing team is responsible for forecasting, ratemaking, financial reporting, product development, and designing pricing strategies to support our Individual line of business. The Senior Actuarial Analyst will report to the Senior Manager of Individual Pricing. In this role, you will be responsible for key forecasting activities, monthly experience and variance reporting, and supporting the development of pricing strategies to achieve both financial and membership growth goals. In addition, you will work alongside a high-performing team and create a lasting impact in making healthcare more accessible and affordable for individual Californians. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive, and predictive analytic methods including forecasting, statistical, and machine learning techniques Conduct and develop analyses, assess risk and population risk scores and assignment, develop pricing and trends, a

We are Farmers! We are... more than just your favorite commercials. At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing customer and business needs. Farmers high-performance culture is focused on results and the people who achieve them. We hold ourselves and others accountable for sustainably growing the business and each other. We seek solutions, own our actions, and grow through discomfort. We see setbacks as opportunities while continuously asking ourselves how we impact our customers. Farmers is an award winning, equal opportunity employer, committed to the strength of a diverse workforce. We are dedicated to supporting the well-being of our people through our extensive suite of benefits, as well as the well-being of the communities we serve through employee volunteer programs and nonprofit partnerships. Helping others in their

Your Role The Actuarial Pricing Shared Services team is responsible for collaborating with different Finance and Actuarial teams to support enterprise financial tracking and forecasting and drive the pricing target setting and planning to meet Company’s operating and growth goals. The Senior Actuarial Analyst will report to the Senior Manager of the Actuarial Pricing Shared Services. In this role you will have visibility into total company financials and enterprise-wide initiatives. You will directly support reporting and forecasting of total company financial with a focus on Gross Margin. There will be exposure to support strategic initiatives on products, as well as impact assessment for legislative changes. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive and predictive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk and population risk scores and

Your Work In this role, you will: Be responsible for converting pricing and financial goals at the line of business and region level into specific action plans at the provider level that the Network team can execute Create value for the Growth team General Managers by ensuring they have a voice when it comes to key network decisions and network strategy Create value for the Network team by organizing and focusing the various requests from the General Managers and Pricing Team into a prioritized, workable list Be required to have strong influencing skills across multiple functions within Blue Shield with a drive towards consensus, and an ability to handle shifting priorities and ambiguity with agility Lead, coordinate and/or develop strategic, market and competitive analysis Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimburseme

Your Role The Large Group Pricing team is responsible for pricing and forecasting our Large Group Health Insurance products. The Experienced Actuarial Analysts will report to the Manager. In this role you will be applying your analytical toolset to project the future costs and premiums for the Large Group customers, as well as additional analysis and reporting for emerging results. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider rei

Your Role The Network and Trend Analytics team drives the development of an affordable provider network through data analytics and expertise. The Experienced Actuarial Analyst will report to the Actuarial Manager. In this role you will manage the unit cost tracking database and be responsible for actuarial analysis and reporting. Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis Coordinate, prepare, perform and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of pricing, trending, r