Manager, Health Finance

4 weeks ago

Honolulu, United States HMSA Full time
  1. Lead the oversight and monitoring of the medical cost trend improvement efforts, by driving cross functional teamwork efforts to identify, design, implement, and monitor initiatives that moderate the Organization's healthcare cost trends:
    • Lead and manage a portfolio of activities with a sharp focus on enhancing healthcare cost outcomes through diversified mitigation strategies.
    • Lead and direct the development of the overall healthcare cost savings/avoidance targets that are aligned with the strategic goals of HMSA.
    • Partner with leadership by providing strategic insight using healthcare cost analytics. Partner with clinical and strategic areas of the business in helping identify and implement programs that impact healthcare costs.
    • Understand the larger healthcare cost picture and creating processes to identify/quantify interactions, and their dependencies of the different initiatives.
    • Partner with Finance, Actuarial, Analytics, and clinical and strategic leaders to ensure that any mitigation initiatives are appropriately contemplated in current/future year projections/pricing models, emerging financial results, and in alignment with other corporate initiatives.
    • Coordinates savings opportunity projections and post implementation savings measurement with other stakeholders.
    • Develops and revises business case and savings estimate capabilities to enable improved accuracy and deeper projections.
  2. Business/Segment Medical Cost Analytics:
    • Partners with analytics teams to facilitate idea generation and quantification of savings initiatives (areas of focus includes but is not limited to provider contracting, utilization management, care management, risk adjustment, operational efficiencies, population health, product design, etc.). Will also ensure quality and accuracy of cost analytics and insights related to claim cost drivers for business segments.
    • Collaborate with analytics teams to verify the quality and accuracy of cost analytics/insights into claim cost drivers for business segment leaders.
    • Regularly meet with senior/executive leadership and Financial Officer(s) of the Health Plan as well as other staff, to set and adjust overall goals and objectives of processes.
    • Provide greater ability to more timely engage, analyze, and implement beneficial but complex financial arrangements.
  3. Consistently work with Health Plan business(s) and functional area partners to develop a pipeline of new initiatives, targeting the achievement of our multi-year financial and trend improvement targets.
  4. Report results regularly, highlighting initiative implementation successes, accountability, activity, progress and identification of barriers.
  5. Lead in a matrixed work environment:
    • Drive new department culture of "creating solutions for the future.
    • Regularly collaborating with business owners and department heads. Ensuring initiatives are being executed and acceptable standards are being met.
    • Provide guidance to other areas who may require financial and analytical expertise.
    • Determine if financial/data projections appear to be unreasonable for the situation and voicing appropriate concerns.
  6. Hire, manage, and develop staff.
    • Assign and manage staff, projects/work assignments, performance management, career development, administration, compensation, recruitment, training, and development.
    • Oversee processes for both operational and strategic activities that are related to procedures, workflows, requirements, and other business activities that impacts members, providers, employee productivity, and morale.
  7. Performs all other miscellaneous duties and responsibilities as directed or assigned.

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