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Skills
Accountingunmatched
Accounting Standards and Regulationsunmatched
Actuarial Skillsunmatched
Analysis Skillsunmatched
Automationunmatched
Centers for Medicare and Medicaid Services (CMS)unmatched
Certified Public Accountant (CPA)unmatched
Content Management Systems (CMS)unmatched
Cost Controlunmatched
Data Entryunmatched
Data Qualityunmatched
Document Managementunmatched
Expense Reportsunmatched
External Auditunmatched
Financeunmatched
Financial Auditunmatched
Financial Complianceunmatched
Financial Statementsunmatched
Flexible Spending Accountsunmatched
Governmentunmatched
Government Fundingunmatched
Health Insuranceunmatched
Healthcareunmatched
Insuranceunmatched
Insurance Regulationsunmatched
Internal Auditunmatched
Interpret Regulationsunmatched
Journal Entriesunmatched
Leadershipunmatched
Maintain Complianceunmatched
Managed Careunmatched
Medicaidunmatched
Medicareunmatched
Mentoringunmatched
Metricsunmatched
Monitor Regulationsunmatched
Process Improvementunmatched
Reconciliationunmatched
Regulationsunmatched
Regulatory Complianceunmatched
Regulatory Reportsunmatched
Regulatory Submissionsunmatched
Reinsuranceunmatched
Requirements Managementunmatched
Riskunmatched
Risk Managementunmatched
SAPunmatched
State Laws and Regulationsunmatched
Time Managementunmatched
Writing Skillsunmatched
Description
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