Director, Market Finance(Must Live in Ohio, Managed Care Experience Required)
Caresource
Job Summary:
Director, Finance – Market provides financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance Department.
Essential Functions:
- Provide timely, accurate comprehensive and transparent financial reporting including, but not limited to, operating statements, trend reports and key business reports as needed to market and corporate leadership
- Responsible for input and review of market finance IBNR models and understanding market cost drivers/trends
- Understand reimbursement methodologies impacting market products
- Support monthly close process by providing journal entries, accruals and supporting analysis as needed. Maintain and distribute the BTL accruals to appropriate teams.
- Responsible for coordinating with market/work stream leaders to identify, implement and measure QAI initiatives to exceed targets
- Support Market’s APM, VBR, ACO, and other delegated arrangement strategies
- Coordinate with actuarial teams on rate advocacy
- Coordinate/liaison revenue maximization efforts (risk adjustment and quality initiatives) between the risk adjustment team, market Contracting/Health Partners teams, and providers
- Participate in pricing strategy of marketplace and other products as appropriate
- Review cost reports and other regulatory filing requirements, interact with regulatory agencies as needed
- Support the annual budget and monthly/quarterly forecasting process for applicable market by providing assumptions, inputs, and review of all market financials
- Coordinate, review and provide feedback to market on their annual admin budget (Market President rollup)
- Provides insight into the risk sensitivity associated with the current and future business drivers
- Support independent financial accounting audits and other regulatory financial related audits
- Perform ad hoc and trending analysis – both proactively and as requested; modeling to support market specific contracting and enhancement initiatives
- Responsible for management of departmental staff and expense budget
- Responsible for making staffing decisions
- Develop, implement, and modify processes to ensure efficiency and effectiveness
- Assess internal controls and make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s Degree in accounting, finance or related field or equivalent years of relevant work experience is required
- Master of Business Administration (MBA) or equivalent graduate degree is preferred
- A minimum of seven (7) years of experience in accounting/finance, to include a minimum of three (3) years of management experience, is required
- Managed care or healthcare experience is preferred
Competencies, Knowledge and Skills:
- Familiar with variety of financial analysis concepts, practices and procedures
- Relies on extensive experience and judgment to plan and accomplish goals
- Familiar with variety of accounting concepts, practices and procedures
- Intermediate proficiency level with Microsoft Office
- Ability to interact with all levels of management, as wells as external audit management
- Ability to multitask and demonstrate flexibility in supporting several market leaders/business areas simultaneously
- Ability to lead and direct the work of others including the development, motivation and rewarding of staff
- Knowledgeable of internal control framework
- Decision making/problem solving skills
- Critical listening and thinking skills analytical skills
- Detail-oriented
Licensure and Certification:
- None
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
- May be required to travel occasionally
Compensation Range:
$132,900.00 - $232,700.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business