Full-Time

Consulting Actuary

Medicare Risk Adjustment

Posted on 2/27/2026

Blue Cross and Blue Shield of North Carolina

Blue Cross and Blue Shield of North Carolina

5,001-10,000 employees

Not-for-profit health insurance provider

Compensation Overview

$117.2k - $222.5k/yr

+ Annual Incentive Bonus

Kansas, USA + 25 more

More locations: Pennsylvania, USA | Iowa, USA | Wyoming, USA | Texas, USA | Florida, USA | South Carolina, USA | South Dakota, USA | Georgia, USA | Arizona, USA | Mississippi, USA | Tennessee, USA | Virginia, USA | Arkansas, USA | Utah, USA | Kentucky, USA | Wisconsin, USA | North Carolina, USA | Oklahoma, USA | Missouri, USA | Ohio, USA | Indiana, USA | Louisiana, USA | Michigan, USA | Alabama, USA | Idaho, USA

Remote

Category
Finance & Banking (1)
Requirements
  • Bachelor's degree or advanced degree (where required)
  • Member of the American Academy of Actuaries
  • Fellow of the Society of Actuaries
  • 7 years of relevant actuarial experience, related experience may be considered.
  • In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.
  • Experience in Medicare Advantage Risk Adjustment highly preferred
Responsibilities
  • Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
  • Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
  • Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
  • Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
  • Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
  • Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
  • Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials
Desired Qualifications
  • Experience in Medicare Advantage Risk Adjustment highly preferred
Blue Cross and Blue Shield of North Carolina

Blue Cross and Blue Shield of North Carolina

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Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides health insurance and health-care services to over 4.3 million members. It uses a not-for-profit model and operates as an independent licensee of the Blue Cross Blue Shield Association, with a focus on improving health and health care across North Carolina. Its products include health insurance plans and related health services designed to help people stay healthier and access care. The company differentiates itself through its not-for-profit status, large regional presence, and commitment to community health, aiming to lead the industry in better health outcomes. Its goal is to make health care better for all by supporting healthier communities and delivering value to its members through quality coverage and services.

Company Size

5,001-10,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Durham, North Carolina

Founded

1933

Simplify Jobs

Simplify's Take

What believers are saying

  • Appointed Anita Brown-Graham vice chair, Eric Fletcher, Brian Fork, Andrew Mueller to board.
  • Signed four-year UNC Health agreement to improve rural patient care access.
  • Federal probe into higher rates concluded without penalty, clearing operations.

What critics are saying

  • Loses NC State Health Plan's 1.1 million members to Aetna in 2025.
  • Mike Causey blocks CuraCor reorganization, restricting asset transfers immediately.
  • Aetna encroaches on commercial market, forcing unsustainable rate cuts now.

What makes Blue Cross and Blue Shield of North Carolina unique

  • CuraCor Solutions holding company enables rapid investments in health technologies.
  • Acquired FastMed's 55 NC clinics in 2024 to expand rural urgent care access.
  • Launched Carolina HealthWorks MEWA in November for small business affordability.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Parental Leave

Family Planning Benefits

Fertility Treatment Support

Career Development Programs

Tuition Reimbursement

401(k) Company Match

Flexible Work Hours

Unlimited Paid Time Off

Paid Vacation

Paid Sick Leave

Paid Holidays

Hybrid Work Options

Wellness Program

Company News

Blue Cross and Blue Shield of North Carolina
Mar 10th, 2026
Blue Cross NC names Anita Brown-Graham as vice chair of Board of trustees; Eric Fletcher, Brian Fork and Andrew Mueller named to Board of trustees.

Blue Cross NC names Anita Brown-Graham as vice chair of Board of trustees; Eric Fletcher, Brian Fork and Andrew Mueller named to Board of trustees. DURHAM, N.C. - Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced the appointment of existing board member Anita Brown-Graham to vice chair of the Blue Cross NC board of trustees and CuraCor Solutions board of directors, the parent holding company of Blue Cross NC. Brown-Graham steps into this leadership role supporting Ned Curran, board chair of Blue Cross NC and CuraCor Solutions. Blue Cross NC also welcomes three new members to its board of trustees: Eric Fletcher, Brian Fork and Andrew Mueller, M.D. Fletcher, Fork and Mueller will also serve as members of the board of directors of CuraCor Solutions. These appointments reflect the organization's commitment to strong strategic guidance across its health care initiatives. The boards consist of community leaders with varied backgrounds in health care, education, business, and finance. "Anita's appointment as vice chair reflects her proven leadership and steady guidance during a period of continued transformation," said Blue Cross NC and CuraCor Solutions board chair Ned Curran. "Additionally, we are fortunate to welcome three board members whose backgrounds span health care delivery, public policy, and complex organizations. Together, this group strengthens our board's ability to provide thoughtful oversight and long-term strategic directions." Eric Fletcher Eric Fletcher is a partner at Brooks, Pierce, McLendon, Humphrey & Leonard, where he advises clients on complex litigation and matters at the intersection of law, public policy, and government. He previously served as General Counsel to former North Carolina Governor Roy Cooper, leading the Governor's legal strategy and advising on executive, legislative, and regulatory matters across state government. A North Carolina native, he holds a bachelor's degree with highest honors from the University of North Carolina at Chapel Hill and a Juris Doctor, magna cum laude, from Harvard Law School. Brian Fork Brian Fork is Chief Executive Officer of Hurricanes Holdings, LLC, where he oversees all business operations of the Carolina Hurricanes, Lenovo Center, and the mixed-use sports and entertainment district under development surrounding the arena. Prior to joining the Hurricanes, Fork served as Chief of Staff and General Counsel to North Carolina Senate President Pro Tempore Phil Berger, playing a lead role in negotiations on major state policy issues, economic development initiatives, and complex litigation matters. Fork holds a bachelor's degree from Davidson College and a Juris Doctor with honors from the University of North Carolina School of Law and currently serves on the Executive Committee of the Greater Raleigh Chamber of Commerce Board of Directors. Andrew Mueller Andrew Mueller, M.D., FAAFP, is President and Chief Executive Officer of MaineHealth, a not-for-profit integrated health system, where he leads system-wide strategy, operations, and financial performance across hospitals, physician practices, research, and a Medicare Advantage health plan. A board-certified family physician, Dr. Mueller brings deep experience in care delivery, value-based payment models, and health system transformation, having previously served as CEO of Centra Health and in senior leadership roles at Novant Health. Dr. Mueller earned his medical degree from the University of North Carolina School of Medicine and a bachelor's degree in electrical engineering from North Carolina State University. The governing board of CuraCor Solutions is composed solely of members of the governing board of Blue Cross NC. Blue Cross NC reorganized as a subsidiary of CuraCor Solutions, remaining a North Carolina-based, not-for-profit, mission-driven company, as authorized by the bipartisan Reorganization & Economic Development Act. This structure allows the organization to more quickly partner and invest in new health programs and technologies that benefit members and drive better, more affordable care for North Carolinians. About Blue Cross and Blue Shield of North Carolina Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the leading not-for-profit health plan in North Carolina, is committed to improving the health and well-being of its customers and communities. Since 1933, the company has developed programs and initiatives that give North Carolinians the opportunity to live healthier lives. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at http://www.bluecrossnc.com. About CuraCor Solutions CuraCor Solutions is a not-for-profit holding company whose family of companies includes Blue Cross and Blue Shield of North Carolina, FastMed LLC, Brighton Healthplan Solutions, ACS Benefit Services (wholly owned subsidiaries), and affiliated entities Echo Health Ventures and Alo Solutions and Avance Care (not wholly owned). CuraCor helps companies nationwide grow and connect to make quality care simpler, more affordable, and easier to access - so that it works better for all. Learn more at www.curacor.com.

Blue Cross and Blue Shield of North Carolina
Nov 3rd, 2025
NC Chamber, Blue Cross NC Partner to Help Small Businesses Afford Health Coverage

NC Chamber, Blue Cross NC partner to help small businesses afford health coverage. RALEIGH, N.C. - With small businesses feeling the impacts of rising health care costs, the NC Chamber has partnered with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to provide a new, more affordable health plan option for small businesses, their employees and their families. Carolina HealthWorks brings together North Carolina small businesses to access more affordable health care through a multiple employer welfare arrangement (MEWA) model. A MEWA offers an alternative to small businesses that allows them to pool their resources and provide access to the rate advantages and benefits typically only enjoyed by larger groups. "Small businesses are the lifeblood of this state," said North Carolina Insurance Commissioner Mike Causey. "Many small business owners have told me about their struggles to find affordable health care for their employees. I applaud the North Carolina Chamber for partnering with Blue Cross NC to create this new option for its small employer members. I also want to give a special thank you to the review team at the N.C. Department of Insurance for going above and beyond in putting in extra hours to make this approval in record time. We need to continue to look for ways to help get more North Carolinians affordable health care." "North Carolina leads the nation in business - but is one of the most expensive states for health care - a sharp contradiction that hits hardest for small businesses fighting to survive," said Gary Salamido, president and CEO of the NC Chamber. "This moment demands real solutions. The creation of Carolina HealthWorks is a meaningful step in giving small businesses a tangible, more affordable path forward. We appreciate Blue Cross NC's willingness to partner and find an affordable, thoughtful solution designed to help small businesses support their teams, their families, and stay competitive." Carolina HealthWorks will be available starting November 1 to North Carolina small businesses that have 2 to 50 employees and are members of either the NC Chamber or a participating local chamber. Carolina HealthWorks has chosen Blue Cross NC to be the administrator for this health plan, offering access to Blue Cross NC's broad network. Small business owners have opportunities to enroll in the plan throughout the year. "Right now, the health care system is shifting, and our market is experiencing immense volatility. It will take partnerships and new ideas to meet this moment," said Tunde Sotunde, MD, CEO of Blue Cross NC. "Our partnership with the NC Chamber, and the launch of Carolina HealthWorks, is an example of a creative collaboration to solve a real problem: the soaring cost of health care for small businesses. Blue Cross NC stands ready to partner with organizations committed to driving down health care costs in North Carolina." According to a national analysis, small businesses bear higher burdens from health insurance costs, representing a higher percentage of payroll costs when compared to larger businesses.[1] In fact, among small businesses that do not offer health insurance, 65% cited cost as the most important reason.[2] The impact of those decisions is significant since more than 94% of businesses in the United States have fewer than 50 employees and more than 27% of private sector employees work in firms with 1 to 49 employees.[3] Carolina HealthWorks is sold through Blue Cross NC appointed agents, allowing businesses to continue working with their existing Blue Cross NC agent. Direct enrollment is available through Blue Cross NC for those not currently working with an agent. More information about Carolina HealthWorks is available on the Blue Cross NC website or the NC Chamber's website. About Blue Cross and Blue Shield of North Carolina: Blue Cross NC, the leading not-for-profit health plan in North Carolina, is committed to making health care more affordable, easier to navigate and accessible for all. Since 1933, the health insurer has created programs and initiatives to provide North Carolinians the opportunity to be healthy. Blue Cross NC serves its customers and communities of more than 4.2 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at bluecrossnc.com. All other marks are the property of their respective owners. About NC Chamber: The NC Chamber works to research, develop, advocate, and communicate for solutions and policies that produce a nationally competitive business climate in North Carolina. For more information, visit ncchamber.com. Disclaimer: Benefits are provided by the NC Chamber Benefit Trust, with excess coverage from a licensed insurer. The Trust isn't backed by a guaranty association but is regulated by the NC Department of Insurance. The NC Chamber is the sponsor and plan administrator of Carolina HealthWorks, which is a self-insured non-plan Multiple Employer Welfare Arrangement. Third-party administrative services are provided by Blue Cross and Blue Shield of North Carolina. The NC Chamber and Carolina HealthWorks are separate entities and do not provide Blue Cross or Blue Shield products or services. North Carolina leads the nation in business: CNBC. (2025, July 10). America's Top States for Business. www.cnbc.com/2025/07/10/north-carolina-top-states-for-business-ranking.html (Accessed November 2025). North Carolina is one of the most expensive states for health care: Data from comparison of all 50 U.S. states and Washington, D.C. on nine metrics between 2020 and 2022. Advisory Board. (2024, April 1). Mapped: The states with the highest (and lowest) healthcare costs. www.advisory.com/daily-briefing/2024/04/01/healthcare-costs (Accessed November 2025).

Yahoo Finance
Nov 13th, 2023
Free and Charitable Clinics Receive $500,000 Grant From Blue Cross NC Foundation to Tackle Oral Health Crisis for North Carolina's Uninsured

Free and Charitable Clinics receive $500,000 grant from Blue Cross NC Foundation to tackle Oral Health crisis for North Carolina's uninsured.

Blue Cross and Blue Shield of North Carolina
Oct 20th, 2023
Blue Cross NC Reaches Agreement to Acquire FastMed's North Carolina Locations

Blue Cross and Blue Shield of North Carolina (Blue Cross NC ) has agreed to acquire all North Carolina-based locations of FastMed.

The Business Journals
Sep 18th, 2023
UPMC Enterprises invests in Sempre Health

Also working with Sempre on the health insurance side are BlueCross BlueShield of North Carolina, Blues in Arizona and Michigan, and others.

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