HCRA Analyst I/II/III

About the Role

The HCRA Analyst is responsible for administering, monitoring, and analyzing activities related to the New York State Health Care Reform Act (HCRA), Federal Affordable Care Act (ACA), extraterritorial state surcharges and assessments, New York State patient-centered medical home incentive payments (PCMH), New York State MCO tax, health risk-based capital filings, and group capital calculation for respective entities. This role ensures compliance with state regulations, supports accurate surcharge and covered lives reporting, reconciles financial data, prepares regulatory submissions, and collaborates with internal and external stakeholders to resolve reporting and reimbursement issues. The analyst serves as a subject matter expert for HCRA regulations and helps identify opportunities to improve reporting accuracy and operational efficiency. This role performs basic financial analysis and/or assists in complex financial analysis for supervisory review.

Responsibilities

• Prepares, validates, and submits HCRA surcharges, Covered Lives counts, Non-NY surcharges, assessments, and other required regulatory filings in compliance with state requirements.
• Analyzes member eligibility, enrollment, and product data to determine reporting obligations and assessment requirements.
• Calculates, validates, and reconciles HCRA surcharges, assessments, and Covered Lives obligations to ensure reporting accuracy.
• Monitors HCRA surcharge activity to ensure accurate assessment, payment, reporting, and regulatory compliance.
• Reconciles reporting data across enrollment, premium billing, membership systems, general ledger accounts, and regulatory submissions.
• Researches and resolves discrepancies related to membership counts, reporting classifications, surcharge calculations, and financial balances.
• Prepares accruals, account reconciliations, financial analyses, management reports, variance analyses, and ad-hoc reporting requests related to HCRA obligations.
• Partners with Finance, Accounting, and internal stakeholders to ensure accurate recording of liabilities and expenses and support month-end close activities.
• Utilizes accounting systems, Cognos, and SAS to analyze claims and membership data, develop reporting solutions, and maintain supporting documentation, controls, and procedures.
• Identifies process improvement and automation opportunities, performs trend analyses, and supports system testing and implementation of regulatory and process updates.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct.
• Maintains high regard for member privacy in accordance with corporate privacy policies and procedures.
• Performs other functions as assigned by management.

Level II Responsibilities

• Evaluates financial performance by comparing and analyzing actual results with plans and forecasts.
• Prepares and analyzes quarterly and annual regulatory filings.
• Coordinates accumulation and evaluation of data from operational units, accounting records, and outside sources to assist in the development of pricing structures.

Level III Responsibilities

• Prepares complex analytical schedules for use by senior leadership in decision-making processes.
• Provides financial support by recommending actions in operational and strategic planning relating to HCRA regulations.
• Monitors compliance with HCRA regulations and communicates changes to impacted stakeholders.
• Monitors regulatory updates and assesses operational and financial impacts to the health plan.
• Reviews remittance activity and payer contracts to identify HCRA reimbursement discrepancies and investigates to achieve resolution.
• Researches and resolves reporting variances, payment discrepancies, and audit inquiries.
• Establishes and analyzes financial benchmarks to drive informed budgeting and planning.
• Oversees the development and analyses of supporting financial schedules, including preparation of worksheets and maintenance of appropriate backup and documentation for internal control and auditing purposes.
• Supports internal and external audits by preparing documentation and responding to auditor requests.
• Develops and maintains policies, procedures, and controls related to HCRA reporting and compliance.

Requirements

• Bachelor’s degree in accounting, business administration, finance, data analytics, or related field. In lieu of a degree, six (6) years of experience required.
• Experience with New York State HCRA, Covered Lives, and state assessments reporting strongly preferred.
• Knowledge of commercial, Medicare Advantage, Medicaid Managed Care, and exchange products preferred.
• Experience working with health plan enrollment, eligibility, claims, or financial data.
• Demonstrated financial knowledge and modeling skills.
• Ability to establish constructive and collaborative relationships with internal and external staff.
• Intermediate analytical skills and problem-solving.
• Proficiency in MS Office Suite.

Level II Requirements

• Three (3) years of financial analysis experience.
• Advanced analytical, critical thinking, and problem-solving skills.
• Demonstrated experience assessing and implementing process improvement.
• Ability to work in an autonomous environment, think critically, and manage multiple tasks.
• Demonstrated knowledge and skill with SAS Enterprise Intelligence tools (Base SAS, SAS EG, SAS Macro, PROC SQL).
• Strong organizational skills and ability to prioritize, multitask, and work in a fast-paced environment.

Level III Requirements

• Five (5) years of progressive financial analysis experience.
• Advanced degree or CPA preferred.
• Ability to apply critical thinking to gathering and analyzing information from a variety of sources, developing and testing solutions to complex problems, creating strategic and intentional plans.
• Detailed knowledge and understanding of Part 86-1 of the Commissioner of Health’s Administrative Rules and Regulations relating to pools (including Health Care Reform Act of 1996).
• Proficient MS Excel skills required.
• Demonstrated proficiency with SAS Enterprise Intelligence tools (Base SAS, SAS EG, SAS Macro, PROC SQL).
• Proven analytics skills, including data mining, evaluation, and visualization.

Physical Requirements

• Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse, and/or phone for three (3) or more hours at a time.
• Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

Pay

Compensation Range(s):

• Level I: Grade E1: Minimum $62,400 - Maximum $84,000
• Level II: Grade E3: Minimum $62,400 - Maximum $106,929
• Level III: Grade E5: Minimum $71,880 - Maximum $129,384

Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill, and education as they relate to the position’s minimum qualifications, in addition to internal equity.

Benefits

• Group health and/or dental insurance.
• Retirement plan.
• Wellness program.
• Paid time away from work and paid holidays.

Schedule

There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.