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Director Finance - Plan
Job ID 2012-20951 # Positions 1
Location US-FL-Tampa
Search Category Finance
Type Regular Full-Time (30+ hours) Posted Date 10/16/2012
Additional Locations ..
More information about this job:
Summary:
*MANAGED CARE EXPERIENCE REQUIRED*
**Hyperion Pillar, SPSS or equivalent, SQL PREFERED**
The Director Finance Plan is responsible for managing the budgeting, forecasting, and financial analysis functions of the health plan to ensure the achievement of membership, premium, medical expense, gross margin, and local SG&A goals on a quarterly and annual basis. Either directly or by managing a team of Performance Managers develop, coordinate and monitor the annual budget, quarterly forecasts, financial statement analysis and interpretation, Work collaboratively with health plan and corporate management in all areas of responsibility to ensure the organization is focused on current results vs. budget, current financial performance trends, and the identification and execution of initiatives to properly manage revenue, medical, gross margin, and SG&A to plan. Provide analytical support to all areas of the Health Plan Operations.
Responsibilities:
Either through direct action or through the Management/Supervision of a team of Performance Managers collectively perform the following:
1. Perform all management functions including supervision, hiring, firing and training of staff.
2. Conduct all personnel reviews, assessments per Associated Services policies.
3. Directly or through the performance of the team define, coordinated topline, medical expense, and local/direct SG&A portions of annual budget process & quarterly forecasts:
a. Drive process with Plan leadership in conjunction with COO coordinate all analysis required for membership, premium yield, medical expense, and local/direct admin by product;
b. Provide all required files to Home Office departments within required timeframes.
4. Provide updated topline and medical projections as needed by the Home Office due to material changes in the business environment (new membership, new product, new provider contract, etc.)
5. On a monthly and quarterly basis, provide necessary information to Actuarial for the medical accruals including:
a. Large cases not in claim experience;
b. Major contract changes not in claim experience;
c. Other utilization or unit cost events not in claim experience.
6. Full participation in monthly operational meetings, financial statement meetings, and medical accrual meetings.
7. On a quarterly basis, provide all necessary information for the other known liabilities, including detailed analysis for auditor review, within required timelines of close process.
8. On a monthly basis, analyze, interpret, and communicate financial statement and medical accrual results to plan leadership for the month, quarter-to-date, and year-to-date:
a. Identify and explain all variances to budget/forecast;
b. Identify trends & key drivers in revenue and medical and roll them into ACT process for action;
c. Assess impact on quarterly and full year budget/forecast targets for topline, medical expenses, gross margin, HBR, and pre-tax/pre-corporate earnings
9. Conduct and manage all required analysis for the ACT program:
a. Identify, assess, document, and monitor all opportunities to maximize revenue and manage medical expenses to budget/forecast through membership, premium rate, unit cost, utilization, and cost containment initiatives;
b. Ensure 150% of gross margin gap to budget/forecast is explained at all times;
c. Fully utilize process tools and methodologies in accordance with Corporate standards.
10. Fully engage with other Plans and Home Office departments to identify, define, and use standard tools and analytical approaches, including use of common data sets. Interaction with Medical Finance, Finance, Medical Management, Claims, Cost Containment, Provider Service Operations, and Premium Reconciliation is expected.
11. Participate and contribute to Best Practice forums with other Plans and Home Office to share initiative successes, share lessoned learned, identify best practices across the company, and identify new initiatives not currently implemented at the Plan.
12. Monitor monthly cost containment activity, including investigation and resolution of adverse changes in collection activity a. Provide direction to Cost Containment Unit for additional expense savings opportunities not taken.
13. Monitor monthly claims production, including investigation and resolution of adverse changes in production statistics and their impact on medical accrual estimates.
14. Monitor monthly supplemental revenue collections such as Maternity kick payments, Newborn kick payment, and reimbursable drugs, including investigation and resolution of adverse changes in collection activity.
15. Monitor, analyze, and report any variances for local and direct administration expenses.
16. Identify and drive opportunities for savings with Plan leadership on a monthly basis.
17. Prepare the analysis to work with Actuarial to understand key drivers of the premium development for each product.
18. Identify and monitor the assumptions and issues in the rate methodology that drive financial success including trend, populations covered, benefits covered, unit cost assumptions, risk adjustment, birth rates, newborn enrollment rules, special populations (i.e. AIDS/HIV), utilization assumptions, and program changes:
a. Communicate to key Plan leadership and ensure they understand the drivers of success underneath the premium rates;
b. Monitor performance against quantifiable drivers of premium rates and resolve adverse variances as they arise.
19. Develop and enhance data collection and analytical tools to support the plan.
Qualifications:
EDUCATION AND EXPERIENCE
Education
Required:
- BA or BS in Accounting, Finance, or Actuarial Science.
Preferred:
- MBA in Accounting, Finance, or Actuarial Science.
Years and Type of ExperienceRequired:
Required:
- 7 years of Finance, Accounting, or Actuarial experience including budgeting, financial statement analysis, provider contract analysis, utilization analysis, and basic underwriting, and 3 years leadership or management experience.
Specific Technical Skills
Required:
- Proficient in Microsoft Windows environment including the Office suite of products, proficiency with database programs such as Microsoft Access, advanced skills in Microsoft Excel, advanced analytical skills, and excellent communication skills.
Preferred:
- Hyperion Pillar, SPSS or equivalent, SQL.
Other:
Required:
- Strong communication skills, both written and oral ability to present information effectively to corporate management, plan management and providers.
- Ability to manage a professional staff of analysts
- Ability to interface effectively with both technical and business owners.
- Ability to function effectively with a minimum of direction, relying on internal motivation and personal experience to analyze problems and seek out solutions.
- Excellent analytical skills and attention to detail.
- Excellent organizational skills; the ability to handle multiple priorities simultaneously with a high quality result.
- Appreciation of cultural diversity towards target population.
SCOPE INFORMATION
- Direct Reports:
- Indirect Reports:
Budgetary $ Responsibility: Entire Plan budget.
PHYSICAL REQUIREMENTS
- Must be able to operate a computer.
- Must be able to operate a telephone.
- Travel required and must be able to travel on common carriers and to adhere to AMERIGROUP s travel policies.
- Standing and sitting for long periods of time.
- Data Entry using repetitive motions of fingers and forearms.
Industry: Managed Care & Health Insurance
Discipline: Accounting & Controls
Experience: 8 - 10 Years
Level: Director
Compensation: Doe
Company: Amerigroup