Senior Manager, Medical Loss Ratio

Job Summary

Providing strategic and operational leadership, the full-time Senior Manager, Medical Loss Ratio will oversee compliance and reporting for Medical Loss Ratio activities, ensuring accurate calculations and timely submissions while working remotely from anywhere in the Continental United States.

Key responsibilities

• Manage the MLR reporting calendar, ensuring accurate and timely submissions to CMS and state regulators
• Lead cross-functional forums to drive decisions and resolve issues impacting MLR results and regulatory compliance
• Oversee MLR performance monitoring, risk assessment, and corrective action plans in partnership with business owners

Required qualifications

• Bachelor's Degree in Finance, Accounting, Actuarial Science, Business, Healthcare Administration, Public Health, or a related field; or equivalent experience required
• 4+ years of experience in healthcare finance, managed care operations, or a related field required
• Experience interpreting federal and state MLR guidance and applying it to complex classification and methodology questions required
• Advanced experience with Excel and reporting/analytics tools required
• CPA, CMA, CIA, or other relevant accounting/audit credential preferred