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Svp, Cfo National Medicare Finance
4 months ago
**Job Summary**:
The person filling this role is an influential leader with internal and external constituents and supports the Executive Leadership Team’s decision-making and advocacy regarding Medicare. She/he provides leadership technical expertise, and direction for the key accountabilities of NMF. The incumbent ensures that the functions, systems and processes for NMF are integrated, coordinated, and continually enhanced including Medicare Advantage and Part D revenues, regulatory requirements and audits, strategic and financial analytics. The Senior Vice President of NMF contributes to a strong control environment and champions continuous process improvement. This requires influence and strong change management skills to gain buy-in from different constituencies including senior executives in support of future direction. This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state and local laws and regulations, accreditation and licensure requirements (if applicable), and Kaiser Permanentes policies and procedures.
**Essential Responsibilities**:
- Provides overall leadership to the management team for all functions in NMF.
- Oversees all aspects of financial management for the Medicare line of business within the organization including the development of information and analysis on key financial and operational data
- Partners with the National Medicare and National & Market Health Plan leaders to develop strategies to drive growth, ensure compliance, and enhance member satisfaction for the Medicare line of business
- Oversees the Fee-For-Service hospital cost reporting for Medicare and Medicaid
- Represents Kaiser Foundation Health Plan as the Medicare CFO in regard to Centers for Medicare and Medicaid Services (CMS) attestations and other interactions with the regulator
- Is a critical financial and strategic thought partner for members of the National Executive Team, the National Health Plan Team, Market, and the Finance Executive Leadership Team to collaborate and optimize processes supporting Medicare
- Presents analysis and modeling data in a way that supports critical decision making to inform and influence key organizational initiatives and planning** **efforts.
- Ensures compliance with regulatory, administrative, and legal requirements by providing leadership, strong technical expertise and extensive use of analytics to ensure appropriate on-going oversight and due diligence
- Establishes appropriate internal controls to support SOX and Model Audit Rule requirements for the Medicare Finance & Risk Adjustment MEGA.
- Stays abreast of industry trends, the evolving regulatory environment, and internal operational changes to assess risks and opportunities
- Represents NMF with internal and external stakeholders, other Kaiser Permanente functions, vendors, and regulatory agencies.
- Recruits, develops, and maintains a high performing, talented, and engaged team.
- Champions innovation and change within the NMF team and more broadly
This position has a target base salary of $432,000 to $540,000 and is eligible for incentive compensation, an executive allowance, comprehensive health, wellness, time off, savings, and retirement benefits, as well as relocation support, as applicable
**Basic Qualifications**:
Experience
- Minimum of fifteen (15) years of progressive financial leadership experience, including a minimum of five (5) years of executive management level experience working directly with senior leaders of a health insurance organization with prior experience working with Commercial, Medicaid, and Medicare Advantage products.
Education
- A Bachelor’s degree in accounting, finance, or a related discipline is required.
License, Certification, Registration
- N/A
**Additional Requirements**:
- Demonstrated track record of developing and leading high performing teams.
- Demonstrated track record in providing financial leadership in a large, complex business, serving as a strategic business partner to the senior team.
- Demonstrated ability to develop strategy, work in partnership with senior level executives across a complex organization and strong knowledge of the Medicare line of business.
- Technically savvy with experience / familiarity with government programs, and analytical tools to support keen oversight of results and forecasts.
- Experience implementing financial controls and reporting systems to improve management capabilities and results.
- Leadership experience working with regulatory agencies and their contract auditors.
- Experience managing a broad range of financial and organizational issues, such as organizational redesign, improving internal controls, and change management.
- Demonstrated political
