Chief Financial Officer (CFO

Chief Financial Officer (CFO)

Reports to:

Chief Executive Officer (CEO); also works the Board of Directors (BOD) the Finance & Audit Committee, and Investment Committee as may be requested by the CEO and the BOD.

Department:
Finance

Organization type:
Nonprofit, corporate health plan

Organization size:
Approximately 315 employees; operates solely within the State of Wyoming (Rocky Mountain Front Range region)

Direct Reporting Functions:
General Accounting, Tax, Payroll, Financial Planning, Finance Operations, Investment, and Treasury; partners with in-house actuary.

FLSA status:
Exempt

Location:

Wyoming; on-site with hybrid flexibility

Scope note:
The organization's Medicare Advantage product is offered through a separate joint venture (JV). This CFO role may serve in an Officer for the JV; those duties are governed by a separate job description and are intentionally excluded from this document, which covers the nonprofit, corporate health plan's core CFO role only.

The Chief Financial Officer (CFO) is the top financial executive for Blue Cross Bue Shield of Wyoming (BCBSWY), a small, mission-driven nonprofit, corporate health plan health plan of approximately 315 employees operating solely within the State of Wyoming. Reporting to the CEO and working with the Board of Directors as requested, the CFO owns the financial strategy, health, and integrity of the organization and is a hands-on leader as well as a strategist.

This is an executive role that sets direction and represents the organization to regulators, auditors, lenders, and partners, while also leading a lean finance team and remaining close to the day-to-day mechanics of accounting, tax, treasury, reserves, budgeting, and reporting. As a nonprofit corporate health plan, the plan measures success by its ability to serve members and sustain the mission—generating operating margins sufficient to protect solvency and reinvest in the community rather than to distribute profit.

The role operates within the distinctive economics of a risk-bearing health plan: revenue is driven by member enrollment and premium, the largest cost is medical claims, and profitability and reserves are governed by the medical loss ratio (MLR), medical cost trend, and disciplined reserve setting. The plan is a single-state, Wyoming-based insurer regulated by the Wyoming Department of Insurance, and it works with the CMS on the plans/programs it serves.

(The organization launched a Medicare Advantage product in the past 2 years through a separate joint venture; that entity is governed and reported separately, as noted above.) The CFO must balance margin and mission against statutory capital, solvency, and regulatory requirements while sustaining the confidence of the Board, regulators, and community partners.

Financial Strategy & Leadership: financial strategy that sustains the plan's margin, reserves, and mission; advise the CEO and Board on the financial implications of enrollment, product, network, and market decisions, serve as a hands-on financial leader for a small organization—setting direction while remaining close to the close, the budget, and the numbers—and build and mentor a lean, capable finance team, and evaluates growth and sustainability opportunities appropriate to the plan's scale, product or service-area expansion, partnerships, and financing.

Medical Economics, Reserves & Actuarial Partnership:
Partner with the plan's actuary (in-house or consulting) on premium rate development, rate filings, and financial advocacy with the Wyoming Department of Insurance and CMS, ensure the adequacy and integrity of claims liabilities, including incurred-but-not-reported (IBNR) reserves and premium deficiency reserves, with appropriate documentation and independent review, owns the financial management of medical loss ratio (MLR) and medical cost trend;

work with clinical, network, and operations colleagues to manage medical expense and improve forecast accuracy, oversees risk-adjustment revenue integrity, including encounters submission and reconciliation and risk-score accuracy, and proactively engages with actuarial team members…