Overview

Job Location:
Manhattan

Overview

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.

Responsibilities

  • 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.

Qualifications

Education:  

  • Bachelor’s Degree in Accounting or related field required. 

Experience:  

  • 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.