Cost Allocation Leader

Emblem Health is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, Emblem Health partners with top hospitals and doctors, including its own Advantage Care Physicians, to deliver quality, affordable, convenient care.

At over a dozen Emblem Health Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information,  .

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• Execute administrative cost allocation processes for Emblem Health and ACPNY, including monthly actuals, quarterly forecasts, annual planning, and financial analysis.
• Oversee updates to allocation drivers to ensure accuracy and transparency with feedback from functional area leaders and product owners.
• Responsible for key statutory reporting and regulatory filings, ensuring accurate reporting, including CAE allocations, MMCOR submissions, QIA submission, Sales & Marketing filings, pricing support, and annual allocation surveys.
• Provide audit, compliance, and financial reporting support through intercompany analysis, allocation reconciliations, manual journal entries, regulatory and audit responses, data validation, and collaboration with Accounting, Actuarial, Systems, and external auditors.

Principal Accountabilities

• Design, implement, and test business logic updates for allocating administrative expenses across the P&L to ensure financial accuracy and integrity
• Ensure accurate, timely planning for monthly GAAP and intercompany administrative expense allocations for Emblem Health and ACPNY, including allocation review, issue resolution, and coordination with Accounting and Systems teams to ensure accurate financial reporting.
• Oversee and partner with department leaders in executing time studies to support allocation methodologies, evaluating vendor contracts, and assisting in contract/SOW terms to support work being performed. Maintain support for external filings.
• Develop Organizational Policies and Procedures to support allocation methodologies.
• Responsible for partnering with leaders throughout the organization to educate and enhance their knowledge of regulatory requirements and ensure Policies are being followed.
• Participate in monthly business leader calls to understand cost allocation drivers and changes in the business which influence allocations.
• Partner with Actuarial leaders with analysis to enable appropriate pricing of customer bids and product offerings.
• Manage Quality Improvement Activity (QIA) documentation; support actuarial analyses and regulatory reporting requirements.
• Partner with functional leaders in conducting time studies to support allocation methodologies, evaluate vendor contract, and consult in contract/SOW terms to support Quality Initiatives performed.
• Provide analyses for external Quality Initiative audits requested by the NYS Department of Financial Services and CMS.
• Provide monthly administrative cost expense reporting to P&L leads that details performance and documents emerging risks and opportunities; identify trends for financial improvement and cost reductions.
• Provide variance explanations and strategic insight to the business utilizing industry best practices to illustrate inconsistencies and provide recommendations on corrective actions or adjustments that are communicated to senior management.
• Complete pricing support as needed based on fixed and variable allocation modeling by product.
• Capture fixed/variable updates and indirect/direct costs while updating allocation model with input from functional area leaders.
• Collect and maintain allocation drivers and business rules in Oracle PCM to ensure accurate cost allocations.
• Support audit, regulatory, and ad hoc requests from internal stakeholders, regulatory agencies, and external auditors, ensuring timely and accurate responses.
• Support required financial analysis for executive leadership as needed.

Qualifications

Education, Training, Licenses, Certifications

• Bachelor's Degree (Required)

Relevant Work Experience, Knowledge, Skills, and Abilities

• 8 – 10+ years of experience in financial reporting and data analysis. (Required)
• 5+ years of relevant…