Director Business Unit Finance -Presbyterian HealthPlan

Location Address

9521 San Mateo NE Albuquerque, NM

The Director of Business Unit Finance is responsible for overseeing all operational financial activities within the health plan. Reporting to the CFO of the health plan, this leadership role involves developing and executing financial monthly financial reporting to support P&L leaders, establishing and monitoring key financial metrics and scorecard targets, providing financial decision support to business operators, coordinating with PHS enterprise FP&A and controller office on annual budgets and capital forecasting.

The Director collaborates closely with PHP business unit leaders and cross‑functional teams to ensure financial objectives are met and aligned with overall company goals. Other duties include preparing management reports, ensuring compliance with internal controls and external regulations, and leading a team of finance professionals. The ideal candidate excels in strategic planning, business partnership, and driving financial performance to support sustainable growth.

Business Unit Finance

• Develops Monthly Operating Reporting finance infrastructure and reporting in partnership with the CFO and leads budget variance analysis and research in conjunction with P&L owners.
• Serves as primary finance support and liaison for P&L leaders, and other PHP LT executives and operators to maintain line of business and product profitability views to guide growth decisions.
• Model financial impacts of new products, market expansions, network changes, and benefit updates in support of product and P&L leaders.
• Support Enterprise FP&A with the annual plan, long range financial plan, and rolling forecasts, incorporating membership, rates, and medical cost trends.
• Provide clear reporting and insights on medical cost trends, utilization, unit costs, and category‑level drivers‑including pharmacy.
• Collaborate with Medical Economics, Network, and Clinical teams to quantify savings and monitor affordability initiatives.
• Partner with Product, Sales, and Actuarial to assess financial impacts of new products, rating strategies, and broker/commission programs.
• Support rate filings, bids, and RFP responses (e.g., Medicare Advantage, Medicaid, Exchange).
• Analyze membership trends‑growth, retention, and mix‑to understand financial implications.
• Work with Actuarial, Quality, and Operations to forecast the financial impact of risk adjustment, Stars/quality programs, and reinsurance/stop‑loss.
• Support as needed actuarial finance on claims completion, IBNR, reserves, and standardized financial metrics.
• Deliver clear financial narratives tied to operational and medical cost drivers.
• Lead planning and oversight of administrative expenses across operational and clinical areas.
• Establish FTE benchmarks and track benefits from transformation initiatives.
• Support Procurement team and development of ROI reviews for key systems and tools.
• Evaluate investments in health plan capabilities and support NPV development for capital expenditure requests.
• Maintain business case rigor, benefit tracking, and post implementation reviews.
• Act as a strategic advisor to Health Plan leadership, translating financial results into actionable insights.
• Lead and develop the finance team to promote customer service, accountability, collaboration, and continuous improvement.

• Bachelor's degree in Finance, Accounting, Economics, or related field required.
• 8+ years of progressive finance experience, including leadership responsibilities.
• Demonstrated experience in health plan finance, payer finance, or managed care (Commercial, Medicare, Medicaid, Marketplace, or ASO).
• Strong expertise in corporate finance and executive‑level financial storytelling.
• Proven ability to partner cross‑functionally and influence decisions in a matrixed environment.
• Advanced analytical skills with ability to connect financial outcomes to operational drivers (claims, utilization, pricing, membership, network strategy).

• MBA, MHA, or Master's degree preferred.
• Experience leading transformation efforts (automation, analytics modernization, process…