Dir, Finance - Market(Must Live In Georgia And Preferred Experience in Managed Care)

CareSource is a management services organization providing support in the healthcare sector. The Director, Finance – Market is responsible for financial oversight and leadership, ensuring collaboration and support for analyses conducted by areas outside the Finance Department.

Responsibilities:

• Provide timely, accurate comprehensive and transparent financial reporting including, but not limited to, operating statements, trend reports and key business reports as needed to market and corporate leadership
• Responsible for input and review of market finance IBNR models and understanding market cost drivers/trends
• Understand reimbursement methodologies impacting market products
• Support monthly close process by providing journal entries, accruals and supporting analysis as needed. Maintain and distribute the BTL accruals to appropriate teams
• Responsible for coordinating with market/work stream leaders to identify, implement and measure QAI initiatives to exceed targets
• Support Market’s APM, VBR, ACO, and other delegated arrangement strategies
• Coordinate with actuarial teams on rate advocacy
• Coordinate/liaison revenue maximization efforts (risk adjustment and quality initiatives) between the risk adjustment team, market Contracting/Health Partners teams, and providers
• Participate in pricing strategy of marketplace and other products as appropriate
• Review cost reports and other regulatory filing requirements, interact with regulatory agencies as needed
• Support the annual budget and monthly/quarterly forecasting process for applicable market by providing assumptions, inputs, and review of all market financials
• Coordinate, review and provide feedback to market on their annual admin budget (Market President rollup)
• Provides insight into the risk sensitivity associated with the current and future business drivers
• Support independent financial accounting audits and other regulatory financial related audits
• Perform ad hoc and trending analysis – both proactively and as requested; modeling to support market specific contracting and enhancement initiatives
• Responsible for management of departmental staff and expense budget
• Responsible for making staffing decisions
• Develop, implement, and modify processes to ensure efficiency and effectiveness
• Assess internal controls and make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements
• Perform any other job duties as requested

Requirements:

• Bachelor's Degree in accounting, finance or related field or equivalent years of relevant work experience
• A minimum of seven (7) years of experience in accounting/finance, to include a minimum of three (3) years of management experience
• Familiar with variety of financial analysis concepts, practices and procedures
• Relies on extensive experience and judgment to plan and accomplish goals
• Familiar with variety of accounting concepts, practices and procedures
• Intermediate proficiency level with Microsoft Office
• Ability to interact with all levels of management, as wells as external audit management
• Ability to multitask and demonstrate flexibility in supporting several market leaders/business areas simultaneously
• Ability to lead and direct the work of others including the development, motivation and rewarding of staff
• Knowledgeable of internal control framework
• Decision making/problem solving skills
• Critical listening and thinking skills analytical skills
• Detail-oriented
• Master of Business Administration (MBA) or equivalent graduate degree
• Managed care or healthcare experience