This position is responsible for directing the fiscal functions of the company in accordance with generally accepted accounting principles issued by the Financial Accounting Standards Board, the Securities and Exchange Commission, State Department of Insurance other regulatory and advisory organizations.
The Director of Finance is responsible for making critical business judgments and recommendations for existing and new business development in the Medicare, Health Insurance Individual, and Commercial Group Exchange and Third Party Administration markets. The incumbent will lead and manage the finances of the organization in collaboration with other health plan executives and report directly to the Chief Executive Officer, CHRISTUS Health Plan. This position will provide a financial report to the Health Plan Boards and be responsible for reporting the financial position of the company to external regulatory agencies.
The incumbent must have a proven financial background with a deep understanding of the managed care insurance business. The incumbent must demonstrate an ability to think strategically while managing both short-term and long-term goals. Strong communication skills are required to communicate strategy to top-level executives while also managing all levels of staff.
- Serves as a corporate officer for Health Plan entities in both Texas and Louisiana with the respective departments of insurance.
- Provides leadership for all health plan financial operations (accounting, budgeting, finance, long-range and capital planning, financial reporting).
- Provides leadership for health plan enrollment, eligibility and billing operations, in coordination with departmental management.
- Leads and directs actuarial function in the annual bid preparation process, risk management initiatives, and other ad-hoc analysis in support of the strategic initiatives of the organization.
- Development and coordination of financial management systems necessary to achieve health plan financial goals.
- Identifies opportunities for improvement and communicates these to senior leadership. Accountable for the profitability of the health plans in conjunction with the CEO and executive team.
- Develops and maintain effective relationships with key contacts at applicable regulatory agencies; function as the primary contact for all financial-related inquiries, including, but not limited to state departments of insurance, state Medicaid agencies, the Department of Defense (DoD) and the Center for Medicare and Medicaid Services (CMS).
- Plans and coordinates all aspects of health plans Finance Committee meetings.
- Develops and presents financial reports as needed to present financial results to key audience e.g. boards, partners, CMS, management, legislators).
- Participates in the health plan's negotiating team for annual State and federal contract renewal and interim rate increases; work with actuaries to develop appropriate rate proposals by category of aid.
- Participates in contract negotiations related to regional expansion.
- Creates cost-benefit analyses to support business, including but not limited to: provider rate negotiations, subcontractor rate negotiations, financial proformas, and provider incentive programs.
- Develops and administers health plan financial policies and procedures.
- Coordinates the preparation of monthly financial statements.
- Ensures required financial reports are filed with appropriate state agencies in a timely, accurate manner.
- Provides support to external and internal auditors.
- Coordinates the approval and processing of operating expenses in accordance with guidelines approved by Finance Committee.
- Establishes credibility throughout the organization with management and the associates in order to be an effective listener and problem solver of people issues.
- Develops specific and measurable performance standards for all direct reports. Holds self and others accountable to goals and standards of department and company.
- Guides and encourages career development to conduct timely performance evaluations and provides open/ongoing constructive feedback to all direct reports.
- Leads by example: Sets an example of personal performance, which encourages excellence and integrity.
- Assists in the establishment and achievement of business objectives for the area of responsibility based upon the company's overall strategic plan and operating goals.
- Maintains current knowledge of and applies all applicable licensing, regulatory and industry standards. Keeps abreast of current industry trends.
- Writes, speaks, and presents clearly and concisely. Thoroughly prepared prior to the beginning of any negotiation or conflict resolution process.
- Assess departments work quality and develop/implements process improvements to improve and achieve regulatory and oversight compliance
Knowledge and Education
- Bachelor's degree in business required.
- Master's degree in Business Administration or related field
- Seven or more years of experience in health plan financial management, with significant experience as a health plan CFO preferred.
- Commercial/Exchange and/or Medicare Advantage plan experience preferred.
- Demonstrates strong interpersonal and project management skills, with an aptitude for building high-performance, cross-functional teams.
- Experience in fostering a culture of embracing new ideas.
- Has managed dynamic and differing needs, interests and viewpoints of multiple stakeholders.
- Demonstrates a strong commitment to the HEALTH PLAN's mission and the people of the company.
- Works independently, accountable for decisions that impact the entire business.
- A strategic thinker and tactical executor who is able to move an agenda from concept to reality and drives results and organizational improvement through performance outcomes.
- Ability to work with culturally diverse groups.
- Makes the best use of resources and creating opportunities; comfortable assessing and taking risks
- CPA Preferred.