Directs and manages the overall financial operations along with administration of its business practices. Has overall supervisory responsibility for internal control, budgeting, contract management, financial statement analysis and presentation, underwriting, policyholder services, claims processing and litigation, reinsurance cessions. Responsible for coordination with the System Accounting team for accurate financial reporting. Will have direct oversight of the Finance and Underwriting departments. This position will also be a member of the executive team for the Health Plan and will responsible for leading coordination or implementations of various system wide initiatives for division.
Education: Bachelor’s degree in Business, Accounting, Finance, or aligned field required, Master’s degree preferred
Experience / Knowledge / Skills:
- 10 years of healthcare finance and/or accounting experience, with at least (7) years health plan experience
- Previous Finance Leadership experience with demonstrated, successful track record
- Working knowledge of regulation regarding self-funded and fully insured health plans (Texas Department of Insurance, CMS, Sarbanes-Oxley, ERISA)
- Knowledgeable and compliant with all relevant laws, rules regulations and accreditation standards and requirement
- Knowledge of GAAP, Statutory Accounting, financial survey documents, and IBNR calculations.
- Prior successful survey and audit experience.
- Prior experience collaborating with Actuaries as well dyadic partners to accomplish goals.
- Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of “we advance health” through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Company
- Administers the underwriting, actuarial, financial and statistical reporting functions in accordance with established policies and procedures. Trains subordinates on the above areas and monitors performance to ensure fiscal responsibilities are fulfilled.
- Understands system policies and procedures in addition to government regulations as appropriate, and ensures that the Health Plan division is in full compliance.
- Oversees the annual budget and month end close processes with responsibility for appropriate System collaboration.
- Develops long and short-range operations plans, which may include service demand analysis, resources availability analysis, and cost benefit analysis of proposed capital and staff expansions as well as business plan preparation.
- Monitors, interprets and analyzes financial performance in realizing established plans and objectives. Identifies and reports undesirable trends and potential business opportunities and makes recommendations for action.
- Directs the preparation of internal financial reports and board reports. Assures the timely and accurate preparation of financial reports and assures that the reports reliably reflect the financial position. Works with the Chief Accounting Officer to ensure timely and accurate financial reporting.
- Presents financial updates to appropriate leadership boards.
- Assumes the lead role in analyzing and exploring means of reducing operating costs and increasing net revenues and cash collections based on knowledge of market trends, financial reports, and statistical information.
- Communicate, collaborate and cooperate with internal and external stakeholders.
- Comply and adhere to all HIPAA regulations and Compliance/Program Integrity requirements.
- Ensures safe care to patients, staff and visitors; adheres to all Company policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
- Partners in Caring – Demonstrates commitment to the Partners-in-Caring process by integrating both Behaviors and Operating Principles in all internal and external customer interactions. Performs duties with accountability, competency, innovation, collaboration, compassion and respect to create the best possible outcomes with exceptional customer experiences.
- Other duties as assigned