Director of ESP Finance
About The Position
Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Harbor Health operates two Programs for All-Inclusive Care for the Elderly (PACE) in Mattapan and Brockton, providing comprehensive healthcare, transportation and social services for more than 580 frail elders. We are currently seeking a talented Director of Finance to join our team at the Elder Service Plan PACE program.
Requirements
- Bachelor's degree in Finance or related field required
- Five years of work experience in a managed care plan including two years managing staff required
- Intermediate proficiency with Microsoft Excel and Office 365 Including Word, Outlook an Teams
- Demonstrated proficiency in database management, navigation, and utilization
- Knowledge of healthcare reimbursement principles including Medicare and Medicaid
- Experience with Medicare risk adjustment factor coding and/or Medicare Part D bid and reconciliation
- Excellent verbal and written communication skills communicating with a wide audience (e.g. physicians, senior managers, patients, finance staff)
- Excellent problem-solving skills
- Highly organized to handle multiple tasks simultaneously under tight deadlines
- Ability to take initiative; work independently and as a team player
- Experience in hospital or other health care billing
- Knowledge of diagnostic coding
Responsibilities
- Leads the annual budget process for the Elder Service Plan.
- Analyzes Monthly Budget to Actual variances and provides financial report to the program Senior Vice President and clinical staff.
- Analyzes utilization and medical expense data and recommends changes for improved efficiency and accuracy.
- Ensures timely and accurate submission of all Risk Adjustment Process System (RAPS) and Prescription Drug Event (PDE) data to Medicare.
- Manages the Medicare Part D bid, reporting and compliance.
- Manages relationship with PBM and pharmacy vendor.
- Acts as subject matter expert on all issues related to finance in a managed care setting.
- Manages Medicaid cost reporting and partners with industry groups on various projects.
- Maintains knowledge of current fiscal regulations for PACE, Medicare and Medicaid.
- Leads contract discussions with hospitals and other medical providers to ensure optimal payment structures for Harbor's Elder Service Plan.
Benefits
- Health, Dental, Vision, Life, & Disability insurance
- 403b Savings Plan
- Generous Paid Time Off plus 11 additional Holidays
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
Director
