Associate Vice President, Finance - Emory Health Plan

Associate Vice President, Finance - Emory Health Plan Join to apply for the Associate Vice President, Finance - Emory Health Plan role at Emory University. Emory Health Plan seeks an exceptional finance leader to architect and execute a $500M growth strategy, scaling operations from $800M to $1.3B over three years. As Associate Vice President of Finance reporting directly to the President of Emory Health Plan, you will drive financial strategy, build scalable infrastructure, and shape the future of healthcare delivery during the most dynamic period in the plan’s 30+ year history.

What You’ll Lead Strategic Financial Leadership ($800M → $1.3B)
• Architect and execute multi-year financial strategy supporting 62% growth while maintaining fiscal discipline
• Lead annual budgeting, forecasting, and scenario planning for $1.3B health plan operations
• Serve as principal financial advisor to President and governance committee on sustainability, benefit design, and strategic investments
• Design pricing strategies, rate-setting methodology, and contribution structures balancing affordability with financial integrity
• Present quarterly to EHP Governance Committee and semi-annually to University Board Risk Management & Actuarial Oversight
• Restructure stop-loss insurance program for $1.3B scale (specific and aggregate coverages)
• Manage $80-100M reserve fund with sophisticated incurred but not reported (IBNR) calculations and actuarial validation
• Oversee relationships with external actuaries for valuations, trends, and strategic consulting
• Conduct stress testing for catastrophic scenarios including pandemics, high-cost therapies, and market disruptions
• Evaluate captive insurance and risk retention strategies appropriate for $1B+ operations Analytics, Utilization & Value-Based Care
• Scale analytics infrastructure from 20M to 35-40M annual claims with advanced predictive modeling and machine learning
• Perform deep-dive utilization analysis identifying cost drivers, trend decomposition, and optimization opportunities
• Expand value-based care arrangements from current baseline to $M% of spend)
• Design and negotiate shared savings/risk contracts with providers including capitation, bundled payments, and ACO arrangements
• Deliver ROI on care management programs and clinical interventions with measurable outcomes Vendor Management & Cost Optimization
• Lead negotiations with TPA, PBM, stop-loss carriers, and specialty vendors managing $50M+ administrative spend
• Generate $30-50M annual savings (3-5% of budget) through strategic contracting, plan design, and operational improvements
• Evaluate and implement innovative cost strategies: reference-based pricing, centers of excellence, direct contracting, specialty drug optimization
• Establish rigorous SLAs, performance guarantees, and vendor score carding for accountability Regulatory Compliance & Governance
• Ensure full compliance with ERISA, HIPAA, ACA, CAA transparency requirements, Mental Health Parity Act, and all self-funded plan regulations
• Oversee Form 5500 preparation, PCORI fees, Medicare Part D reporting, and regulatory filings
• Lead audit preparedness and coordinate with external auditors, DOL, and regulatory agencies
• Develop compliance management system with controls, documentation, and audit trails Transformation & Innovation
• Drive adoption of emerging technologies: AI/ML for predictive analytics, RPA for automation, cloud-based financial systems
• Lead major VBC transformation initiatives
• Champion continuous improvement using Lean/Six Sigma to optimize operations for scale
• Build data-driven culture with self-service analytics, real-time dashboards, and advanced modeling capabilities What You Bring Required Experience
• Bachelor’s degree in Finance, Accounting, Health Care Administration or related field and 10 years of progressive financial leadership experience, including direct experience with self-funded health plans, academic institutions or integrated health systems.
• MBA, MHA, MPH or other related master’s degree strongly preferred.
• CPA, CMA, FSA or ASA strongly preferred.
• Progressive healthcare finance…