The GovernmentBusiness Division Finance Director is responsible for financialleadership, decision support, and strategic consultation to the leadership teamin the Health Plan. This role directs health plan trend analysis, cost ofcare, financial reporting and analysis, financial operations, cost and budgetmanagement and administrative allocations in the Ohio Medicaid Health Plan, andserves as a key liaison and subject matter expert with our state customer on medicaltrends, financial/reimbursement policy, payment mechanisms and financialimplications of program and benefit changes.Primaryduties may include, but are not limited to: Health plan P owner along with plan president and other functional leaders. Serves as key health plan leader providing financial and strategic insight to other health plan functional areas; operates as a liaison with state partners; leads reimbursement management and negotiation; owns the Medical Cost Trend, cost of care process for plan and mitigation initiatives; and reviews financial statements, reserve development and financial analytics. Partners with pricing actuaries to ensure that premium reimbursement is adequate to cover medical trends, administrative expenses and profit. Reviews, analyzes, and presents financial results to health plan and line of business leadership as well as the board of directors. Provides decision support for health plan leadership team for operational and business goals. Directs health ) Achieves Medical Cost, MLR and operational income targets set in forecasts; ensures that provider network contracting obtains optimal financial arrangements; co-develops the setting of Cost of Care (CoC) targets and is responsible for CoC execution. Directly interfaces with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability. Requires a BS/BA in Finance, Business Administration, or Accounting; 8-10 years of progressive financial experience with strategic and tactical planning, medical trend or business analytics, budgeting/forecasting, and accounting or financial reporting within a health insurance or managed care environment; experience with complex business environments and highly regulated situations; or any combination of education and experience, which would provide an equivalent background. MBA preferred. AnEqualOpportunityEmployer/Disability/Veteran
20 hours ago
Mason, Ohio
Anthem Inc.
Full Time