Dir, Finance - Market(Must Live In Georgia And Preferred Experience in Managed Care)
About The Position
The Director, Finance – Market provides financial oversight, leadership, and support to the market/corporate. This role ensures the department proactively collaborates with and provides support for analyses conducted by areas outside the Finance Department. The position is responsible for input and review of market finance IBNR models, understanding market cost drivers/trends, and supporting reimbursement methodologies impacting market products. It also involves supporting the monthly close process, maintaining BTL accruals, and coordinating with market/work stream leaders to identify, implement, and measure QAI initiatives. The Director will support various delegated arrangement strategies, coordinate with actuarial teams on rate advocacy, and liaise revenue maximization efforts between different teams. Additionally, this role participates in pricing strategy, reviews cost reports and regulatory filings, supports the annual budget and forecasting process, and provides insight into risk sensitivity. The Director is also responsible for performing ad hoc analysis, managing departmental staff and budgets, developing processes for efficiency, assessing internal controls, and performing any other job duties as requested.
Requirements
- Bachelor’s Degree in accounting, finance or related field or equivalent years of relevant work experience is required.
- A minimum of seven (7) years of experience in accounting/finance, to include a minimum of three (3) years of management experience, is required.
- Familiar with variety of financial analysis concepts, practices and procedures.
- Relies on extensive experience and judgment to plan and accomplish goals.
- Familiar with variety of accounting concepts, practices and procedures.
- Intermediate proficiency level with Microsoft Office.
- Ability to interact with all levels of management, as wells as external audit management.
- Ability to multitask and demonstrate flexibility in supporting several market leaders/business areas simultaneously.
- Ability to lead and direct the work of others including the development, motivation and rewarding of staff.
- Knowledgeable of internal control framework.
- Decision making/problem solving skills.
- Critical listening and thinking skills.
- Analytical skills.
- Detail-oriented.
Nice To Haves
- Must Live In Georgia
- Master of Business Administration (MBA) or equivalent graduate degree is preferred.
- Managed care or healthcare experience is preferred.
- Experience in Managed Care is preferred.
Responsibilities
- Provide timely, accurate, comprehensive, and transparent financial reporting, including operating statements, trend reports, and key business reports.
- Responsible for input and review of market finance IBNR models and understanding market cost drivers/trends.
- Understand reimbursement methodologies impacting market products.
- Support monthly close process by providing journal entries, accruals, and supporting analysis.
- Maintain and distribute BTL accruals to appropriate teams.
- Coordinate with market/work stream leaders to identify, implement, and measure QAI initiatives to exceed targets.
- Support Market’s APM, VBR, ACO, and other delegated arrangement strategies.
- Coordinate with actuarial teams on rate advocacy.
- Coordinate/liaison revenue maximization efforts (risk adjustment and quality initiatives) between the risk adjustment team, market Contracting/Health Partners teams, and providers.
- Participate in pricing strategy of marketplace and other products as appropriate.
- Review cost reports and other regulatory filing requirements, interact with regulatory agencies as needed.
- Support the annual budget and monthly/quarterly forecasting process for applicable market by providing assumptions, inputs, and review of all market financials.
- Coordinate, review, and provide feedback to market on their annual admin budget (Market President rollup).
- Provides insight into the risk sensitivity associated with the current and future business drivers.
- Support independent financial accounting audits and other regulatory financial related audits.
- Perform ad hoc and trending analysis – both proactively and as requested; modeling to support market specific contracting and enhancement initiatives.
- Responsible for management of departmental staff and expense budget.
- Responsible for making staffing decisions.
- Develop, implement, and modify processes to ensure efficiency and effectiveness.
- Assess internal controls and make appropriate changes to ensure compliance with MAR, regulatory, and other organization requirements.
- Perform any other job duties as requested.
Benefits
- Substantial and comprehensive total rewards package.
- May qualify for a bonus tied to company and individual performance.
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What This Job Offers
Job Type
Full-time
Career Level
Director
