Finance Manager
4 weeks ago
Under the direction of the Director of Finance or designee, manages staff and processes for strategic initiatives and analysis for the health plan.
This role is responsible for leading financial analysis and medical economics for the health plan. Oversees finance activities for Medicare line of business. Analyzes and reviews financial performance reporting of network providers. Leads medical cost action plan process to achieve cost savings or revenue increases for the health plan. Supports provider network department on analysis for provider contracting. Interacts with actuarial team to evaluate health plan rate setting and risk adjustment. Leads health plan cost reporting processes with Medicaid agency.
Key Responsibilities- Manages and oversees work of direct reports within the finance department
- Implements strategic finance initiatives for the health plan to ensure success and timely completion, including developing and monitoring targets and measures
- Leads health plan cost reporting processes with Medicaid agency
- Oversees finance activities for Medicare lines of business
- Plans, conducts, and directs work on complex projects and initiatives
- Manages the financial analysis of medical costs and development of action plans to reduce cost and utilization, including leading medical cost action plan initiatives
- Provides analysis and recommendations for provider contracting
- Leads processes to evaluate provider performance across multiple metrics such as cost and utilization
- Develops and implements plans related to performance variances
- Reviews government reforms, budgetary, and legislative changes to determine impact on health plan
- Bachelor's degree from an accredited college or university with five (5) years of healthcare finance experience
- Prior experience in financial analysis and provider performance reporting within a healthcare setting
- Intermediate proficiency using Microsoft Office products
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