Vacancy caducado!
Description SHIFT: Day JobSCHEDULE: Full-timeResponsible for
financial leadership, decision support, and strategic consultation to the
Empire BCBS HealthPlus leadership team. Directs health plan financial analysis,
cost of care analytics, trend analysis, financial reporting, financial
operations, and cost and budget management and allocation, which may include
specialty products and/or provider contracting arrangements that carry
financial risk to the plan P&L. Serves as legislative consultant with state
partners on financial/reimbursement policy and payment mechanisms. Primary duties may
include, but are not limited to:
Directs market leadership for P&L
and SG&A budget; operates as a financial liaison to state
partners;
Leads rates management and negotiation
including reserve development and analytics; and leads the Medical Cost
Trend identification and mitigation process.
Maintains trends that are appropriate
given premium reimbursement.
Reviews, analyzes, reports, and
presents financial results.
Provides decision support for business
unit President and senior management teams’ operational and business
goals.
Directs health plan preparation of
overall budget, forecast, and cost allocation processes.
Achieves Medical Cost and MLR targets
set in plans and forecasts; may ensure that provider network contracting
efforts obtain the best possible financial arrangements; may own the
setting of and achievement of Cost of Care targets; and achieves operating
gain targets set in budgets and forecasts.
Directs Health Plan preparation of
annual operating/capital budget and quarterly forecasts to provide senior
leadership with tools necessary to maximize investment of resources.
Directs interface with regulatory and
audit personnel and technical consultants as required to ensure fiscal
accountability.
Hires, trains, coaches, councils and evaluates
Qualifications Requires a BS/BA in Finance, Business Administration, or Accounting; 8-10 years of progressive financial experience in accounting, financial reporting, business analysis, budgeting, forecasting, and strategic and tactical planning within a health insurance/managed care environment; experience with complex business environments including multiple entity and highly regulated situations; 5 years management experience; or any combination of education and experience, which would provide an equivalent background.; MBA preferred.Significant
experience with value based purchasing, agreements, and provider data is a
plus. Medicaid knowledge preferred. AnEqualOpportunityEmployer/Disability/VeteranREQNUMBER: PS35987
Vacancy caducado!