Overview:
Leads statutory accounting and regulatory reporting activities for Medicare and Medicaid health insurance entities. Ensures full compliance with NAIC Statutory Accounting Principles (SAP), CMS, and state insurance department requirements, and serves as a key point of contact for regulators, auditors, and internal stakeholders.
Responsibilities:
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
What You Will Do
- Leads preparation, review, and filing of quarterly and annual NAIC statutory financial statements for Medicare and Medicaid lines of business.
- Ensures ongoing compliance with NAIC SAP, CMS regulations, state insurance laws, and Medicaid managed care requirements.
- Prepares and reviews complex statutory schedules and exhibits, including premium and membership reporting, claims and medical expense reporting, reinsurance and risk-sharing arrangements and risk-Based Capital (RBC) and surplus analysis.
- Monitors statutory capital, surplus, and solvency metrics to ensure regulatory compliance.
- Serves as a primary point of contact for state insurance departments, CMS, and the NAIC.
- Coordinates and supports statutory audits, financial examinations, and CMS program audits.
- Prepares formal responses to regulator inquiries, data calls, and examination findings.
- Ensures timely and accurate filing of all regulatory reports and supplemental schedules.
- Interprets and applies complex statutory accounting guidance related to Medicare Advantage and Part D, Medicaid managed care contracts, and programs such as risk adjustment, cost‑sharing reductions, and premium stabilization.
- Reviews journal entries and account reconciliations impacting statutory results.
- Assesses statutory accounting implications of new products, contracts, or regulatory changes.
- Partners closely with actuarial, compliance, finance, and government programs teams to validate data inputs and assumptions.
- Collaborates with legal and compliance teams on regulatory interpretations and filings.
- Provides statutory accounting guidance to internal stakeholders and junior staff.
- Maintains and enhances statutory reporting controls, documentation, and governance.
- Identifies and implements process improvements and automation opportunities.
- Stays current on emerging NAIC, CMS, and state regulatory guidance affecting Medicare and Medicaid insurers.
- Supports enterprise compliance initiatives and regulatory readiness.
- Participates in special projects and performs other duties as assigned.
Qualifications:
Licenses and Certifications:
CPA or CPA candidate preferred
Education:
Bachelor's Degree in Accounting or Finance required
Work Experience:
- Minimum 7 years of accounting experience, including significant statutory insurance accounting experience required
- Deep knowledge of NAIC SAP, health insurance regulations, and government-sponsored health programs required
- Hands-on experience with statutory filings for Medicare Advantage, Part D, and/or Medicaid managed care entities required
- Strong experience interacting with regulators and external auditors required
- Prior experience with CMS reporting and audits preferred
- Experience with multi-state health insurance operations preferred
- Familiarity with statutory reporting systems and NAIC filing tools preferred
- Expert understanding of statutory accounting and regulatory compliance required
- Strong judgment and ability to interpret complex regulatory guidance required
- Excellent written communication for regulator correspondence required
- Ability to manage high-risk deadlines in a regulated environment required
- Leadership mindset with the ability to mentor and review work of others required
Pay Range:
USD $98,200.00 - USD $130,800.00 /Yr.