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Director of Financial Planning and Analysis

2 months ago

Boston, United States WellSense Health Plan Full time

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Directs financial planning and associated analysis activities at a leading health plan with a large market share of Medicaid lives in Massachusetts and New Hampshire, as well as Commercial and Medicare lines of business. Overseeing a team of 4-6, this key finance leader is responsible for consolidating the annual financial budget and quarterly reforecast projections across the major product lines, leading the financial forecasting and analysis of Medicaid lines of business, and summarizing the drivers of emerging financial results for various levels of senior leadership.

Our Investment in You:

* Full-time remote work

* Competitive salaries

* Excellent benefits

Key Functions/Responsibilities:

  • Lead the development and consolidation of financial projections across all product lines for the annual fiscal year budget, vetting all typical P&L line assumptions, incorporating any cost savings initiatives, and possessing a clear understanding of all potential upside and downside variables, and analyzing likely range of outcomes and associated impact to operating income before and after risk sharing arrangements
  • Lead development of presentations summarizing the drivers of monthly variance between actual results and budget that are appropriate for various audiences ranging from the system CFO, the finance committee of the board, the health plan board, senior leaders at the health plan, and all staff presentations
  • Developing financial reforecasts for the current fiscal year as needed, typically on a quarterly basis, and summarizing key variances to budget and risks / opportunities for senior leaders
  • Leading annual development and communication of the long range forecast, looking out 4 years beyond the current fiscal year, incorporating strategic growth initiatives identified by senior management
  • Act as primary point of contact for financial projections and analysis of Medicaid lines by overseeing regular updates to internal financial forecast models, and performing annual rate adequacy analyses, including vetting of key assumption used by state actuaries in annual rate setting process, summarizing impact of any rate changes for senior leaders and advocating for program or assumption changes to mitigate potential adverse financial performance
  • Oversee monthly analysis and establishment of various concurrent risk score updates, market and plan risk sharing, stop loss, and other accruals related to Medicaid lines of business, including associated annual settlements with state agencies
  • Analyze financial impact of significant program changes and impacts of enrollment changes for Medicaid lines and summarize for senior leaders
  • Work closely with the finance team responsible for regulatory reporting to state agencies and ACO joint venture partners to ensure latest known accruals, state simulations and projections are being shared
  • Prepare quarterly profitability analysis summaries for Medicaid lines of business, focusing on variance to pricing targets set by state actuaries, and including relative performance to competitors in the market, and share with various teams across finance and the BMC health system, like population health and system analytics
  • Other duties as assigned

Supervision Exercised:

  • Provides weekly supervision to 4-6 staff

Supervision Received:

  • Supervision and support is received weekly and as needed

Qualifications:

Education Required:

  • Bachelor's Degree in Finance, Health Care Administration, or related field

Education Preferred:

  • ASA or FSA designation preferred

Experience Required:

  • 5-10 years of related Financial Planning & Analysis experience
  • A background in managed healthcare with exposure to senior leadership

Experience Preferred/Desirable:

  • Experience in Medicaid product lines
  • SAS/SQL coding experience

Required Licensure, Certification or Conditions of Employment:

  • Successful completion of pre-employment background check

Competencies, Skills, and Attributes:

  • Effective collaborative and proven process improvement skills.
  • Strong oral and written communication skills; ability to interact within all levels of the organization.
  • A strong working knowledge of Microsoft Office products, especially Excel.
  • Working understanding of SAS or SQL or similar database query tools.
  • Demonstrated ability to successfully plan, organize and manage projects
  • Detail oriented, excellent proof reading and editing skills.

Working Conditions and Physical Effort:

  • Regular and reliable attendance is an essential function of the position.
  • Work is normally performed in a typical interior/office work environment.
  • No or very limited physical effort required. No or very limited exposure to physical risk.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees