Finance Director - Health Plan

HealthPartners is hiring a Director of Finance - Health Plan. The Director will be responsible for providing financial support, analysis and guidance to achieve financial goals for the Health Plan Pharmacy Division, Provider Contracting and Commercial Line of Business. This will include long-range financial planning, quarterly forecasts and annual budgets.

MINIMUM QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  
  
  
  • Bachelor's degree in accounting or finance.
  • 10+ years of experience in finance and/or accounting.
  
  
• Knowledge, Skills, and Abilities:
  
  
  
  • Experience managing exempt employees.
  • Excellent analytical skills.
  • Advanced oral and written communication and presentation skills.
  • Must possess strong consultative, problems solving and teamwork skills.
  
  
• Strong knowledge of financial modeling, analysis and accounting principles and practices.

PREFERRED QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  
  
  
  • MBA
  
  
• Licensure/ Registration/ Certification:
  
  
  
  • CPA, CMA
  
  
• Knowledge, Skills, and Abilities:
  
  
  
  • Oracle experience
  • Health Plan experience
  
  

ESSENTIAL DUTIES:

1. (40%) - Provide Financial guidance and support to Health Plan Pharmacy Division including:
   
   
   
   1. Oversee financial reporting, budgeting, forecasting and long-range planning for the pharmacy division. Meet with Pharmacy leaders to review financials and partner on any financial analysis needed. Identifies and communicates problem areas which may affect financial performance. Works with leaders on corrective action plans to meet financial goals when appropriate.
   2. Develops key trend assumptions working with Actuarial department for pharmacy claims trends.
   3. Provide financial guidance and review of the Pharmacy Benefit Manager relationship including understanding contractual terms on agreement, partnering with pharmacy and underwriting to achieve financial goals related to pharmacy.
   4. Provide financial oversight for MTM pharmacy and Specialty Pharmacy Operations
   
   
2. (20 %) - Provide financial leadership to provider contracting including the following activities:
   
   
   
   1. Lead team that supports provider withhold arrangements and value-based-care arrangements, including settlement process with providers
   2. Partner with Provider contracting to set financial goals for provider contracts
   3. Partner with informatics, health & care engagement and IS to develop, implement and administer Value Based Agreements (Total cost of care, case rate, capitation, P&L)
   4. Management of reimbursement methodologies that vary from traditional fee schedule (e.g. case rate, capitation)
   5. Responsible for collaborating with provider contracting, informatics and actuarial in claims trends projections.
   6. Partnership with Actuarial in setting of monthly claims IBNR
   7. Analysis and review of monthly claims and drivers and participating in recommendations on actions for improvement
   8. Partner with SVP of Commercial Growth in achieving financial goals
   9. Provide financial reporting, budgeting, forecasting and long-range planning for commercial lines of business. Identifies and communicates problem areas which may affect financial performance. Works with leaders on corrective action plans to meet financial goals when appropriate.
   10. ROI Analysis on projects impacting commercial lines of business
   11. Lead other ad-hoc financial analysis as needed
   
   
3. (10 %) - Claims Management and IBNR Oversight
4. (15%) Commercial Line of Business financial support
5. (5%) Other Ad-hoc Financial Support
6. (10%) Management of Staff including the following:
   
   
   
   1. Supervises 3-4 financial analysts
   2. Carries out supervisory responsibilities including having the authority to hire, transfer, lay off, promote, discipline and discharge, train, reward and conduct performance reviews of direct reports. Ensures compliance to organizational and departmental policies and procedures.
   3. Provides coaching to team members for career growth and performance optimization.