Director Managed Care Finance - Sharp Corporate - Day Shift - Full Time
About The Position
To oversee and direct the operations of the Managed Care Finance department. Responsible for the capitation revenue management and the development and provision of information to Financial Services, Contracts, Medical Groups, Hospitals, Claims Processing, Utilization Review and Patient Financial Services. To direct and oversee the operations of the Managed Care Finance department, including the development of financial analyses of capitation revenue, payor risk pools, health plan incentive programs, stop-loss activity, insured services, sub-capitated providers, and hospital sub-capitation arrangements. Provide personnel management for Managed Care Finance, including training and professional development. To develop and oversee the production of monthly medical group financial reports detailing such information as enrollment, bed days, encounters, risk-pool capitation payments and costs per member per month, incentive funds, etc., to allow for the effective monitoring of managed care contract financial results and physician practice patterns. To recommend and effectively communicate with, Senior Management, Contracts, Claims Administration, Financial Services, Patient Financial Services, Utilization Review, Medical Groups and Hospitals. Develops and maintains managed care financial policies and procedures. Develops and monitors departmental operating and capital budgets and assists management in the preparation and monitoring of System budgets. Participates on the Sharp Rees-Stealy Risk Pool Committee and various committees and task forces, as requested.
Requirements
- Bachelor's Degree in Accounting or Finance.
- 5 Years Experience with a large medical group and hospital managed care accounting and financial analysis.
- 4 Years management experience.
Nice To Haves
- Master's Degree in Finance, Healthcare, or Financial Management.
- Certified Public Accountant (CPA) - CA Board of Accountancy - PREFERRED
Responsibilities
- Oversee and direct the operations of the Managed Care Finance department.
- Responsible for the capitation revenue management
- Development and provision of information to Financial Services, Contracts, Medical Groups, Hospitals, Claims Processing, Utilization Review and Patient Financial Services.
- Direct and oversee the operations of the Managed Care Finance department, including the development of financial analyses of capitation revenue, payor risk pools, health plan incentive programs, stop-loss activity, insured services, sub-capitated providers, and hospital sub-capitation arrangements.
- Provide personnel management for Managed Care Finance, including training and professional development.
- Develop and oversee the production of monthly medical group financial reports detailing such information as enrollment, bed days, encounters, risk-pool capitation payments and costs per member per month, incentive funds, etc., to allow for the effective monitoring of managed care contract financial results and physician practice patterns.
- Recommend and effectively communicate with, Senior Management, Contracts, Claims Administration, Financial Services, Patient Financial Services, Utilization Review, Medical Groups and Hospitals.
- Develops and maintains managed care financial policies and procedures.
- Develops and monitors departmental operating and capital budgets and assists management in the preparation and monitoring of System budgets.
- Participates on the Sharp Rees-Stealy Risk Pool Committee and various committees and task forces, as requested.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Manager
