Remote MLR Audit Manager (Examiner-in-Charge)

Examination Resources, LLC; Northern (KY); Hybrid; USD 100,000 - 130,000; Full time

Job summary

Examination Resources, LLC seeks an Exam Manager / Examiner-in-Charge to oversee comprehensive MLR examinations for federal and state clients, ensuring compliance with procedures established by CCIIO/HHS. The role is remote, with no travel.

You will lead exam teams, review work papers, analyze premium and claims data using ACL or similar tools, and guide staff toward high-quality findings. A background in healthcare auditing and leadership is highly valued.

Qualifications

• Prior audit/examination management experience is required.
• Experience with MLR or healthcare auditing or accounting is required.
• Bachelor's Degree in Accounting or Finance is preferred, but not required.
• Ability to obtain CPA, CIA, CFE, and/or AFE designations.
• 3+ years’ experience as an accountant, auditor, examiner or analyst with a state insurance department, public accounting firm, or related entity.
• Experience leading others.
• Knowledge of the NAIC Accounting and Practices and Procedures Manual.
• Excellent written and verbal communication skills.
• Strong interpersonal, presentation, analytical and examination/audit skills.
• Excellent organizational skills and ability to prioritize multiple tasks.

Responsibilities

• Oversee work streams and staff examiners; maintain exam/project schedule.
• Manage interactions with examinee company contacts.
• Supervise multiple examiners; provide guidance as needed.
• Complete MLR examination procedures.
• Review work papers for accuracy and organization.
• Provide input on performance for supervised examiners.
• Analyze premium and claims data with ACL to select samples and create reports.
• Obtain continuing education for credentials.

Skills

Audit management

MLR/auditing

Communication skills

Leadership

Time management

Microsoft Office

Data analysis

Self-motivation

Independent work

Education

Bachelor's in Accounting/Finance

CPA/CIA/CFE/AFE designations

Tools

ACL

Tableau

Power BI

Excel

Job description

Examination Resources, LLC seeks an Exam Manager / Examiner-in-Charge to oversee comprehensive MLR examinations for federal and state clients, ensuring compliance with procedures established by CCIIO/HHS. The role is remote, with no travel.

You will lead exam teams, review work papers, analyze premium and claims data using ACL or similar tools, and guide staff toward high-quality findings. A background in healthcare auditing and leadership is highly valued.