Prepares cost and operating reports for governmental, third-party organizations, and other regulatory reporting for CHOICE Health Plans. Performs financial forecasting in regulatory formats. Works under general supervision.
- Prepares and submits annual/quarterly Medicaid Managed Care Operating Reports (MMCOR) to NYS Department of Health (NYSDOH), NYS Department of Insurance, and other regulatory financial reporting in accordance with NYSDOH guidelines.
- Prepares NYS Department of Health Managed Long-Term Care (MLTC) and Medicaid Advantage Plus (MAP) Operating Reports. Evaluates changes in regulatory requirements and modifies reports as necessary.
- Prepares Quarterly YTD Statutory Balance Sheet in collaboration with CHOICE Finance Team.
- Submits quarterly Freedom of Information Law requests to New York State for competitor regulatory reporting, including follow up requests as necessary.
- Prepares and submits Medical Home pass-through payment documentation and coordinates with Accounts Payable to ensure timely and accurate payments to providers.
- Performs analyses in response to NYSDOH inquiries regarding previous report submissions,
- Participates in team preparation of other report requests from NYSDOH impacting future premium adjustments and/or penalties.
- Collaborates with IT to create/modify reports to ensure specifications meet department needs.
- Supports the development of certified financials as needed, with emphasis on cross-walk between regulatory and certified reports.
- Participates in special projects and performs other duties, as required.
- Bachelor’s Degree in Accounting or related field required.
- Minimum of four years of experience working in finance related positions which includes accounting, budgeting, financial analysis, or financial planning required.
- Programming experience in SAS/SQL required.
- Experience with medical claims, encounter reporting or MMCORS preferred.
- Experience working with Workday Financials, specifically general ledger, preferred.
- Knowledge of Statutory Accounting Principles preferred.
- Experience with New York State Managed Long-Term Care or other Managed Care products preferred.
- Ability to handle multiple priorities and work well both independently and as part of a team required.
- Experience in communicating and creating presentations for Executive level and DOH leader consumption.