Exam Manager – MLR exams

Position Overview The Exam Manager / Examiner-in-Charge (EIC) will ensure the successful completion of comprehensive Medical Loss Ratio (MLR) Examinations in accordance with the procedures and processes developed by the Center for Consumer Information and Insurance Oversight (CCIIO), a division of the Department of Health and Human Services (HHS) responsible for implementation of the Affordable Care Act (ACA). Examinations may also be performed on behalf of various state insurance departments. Experience with MLR or healthcare insurance auditing or accounting required. Experience with MLR and rebate requirements, or accounting/auditing in the healthcare, insurance, banking and/or Pharmacy Benefit Management (PBM) industries a plus, highly desired. All work is expected to be completed remotely; no travel required. Specific Duties and Responsibilities Oversee work streams and staff examiners; maintain exam/project schedule. Manage interactions and communications with examinee company point(s) of contact. Supervise multiple examiners; provide guidance and assistance to examiners as needed. Complete MLR examination procedures to supplement work of other staff, as necessary. Perform detailed reviews of examination work papers completed by other staff, ensuring accurate and organized work papers are prepared in accordance with the expectations of federal and state government clients, as applicable. Provide input on performance for those examiners supervised. Manage the analysis of