Dir, Finance - Market(Must Live In Georgia)

Job Summary:

Director, Finance – Market provides financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance Department.

Essential Functions:

Provide timely, accurate comprehensive and transparent financial reporting including, but not limited to, operating statements, trend reports and key business reports as needed to market and corporate leadership

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 as needed.  Maintain and distribute the BTL accruals to appropriate teams.

• Responsible for coordinating 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

Education and Experience:

• Bachelor’s Degree in accounting, finance or related field or equivalent years of relevant work experience is required
• Master of Business Administration (MBA) or equivalent graduate degree is preferred
• A minimum of seven (7) years of experience in accounting/finance, to include a minimum of three (3) years of management experience, is required
• Managed care or healthcare experience is preferred

Competencies, Knowledge and Skills:

• 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

Licensure and Certification:

None

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time

May be required to travel occasionally