AVP, Market Finance - Tricare; Military & Managed Care

Job Summary

The AVP, Market Chief Financial Officer provides financial oversight, leadership and support to the region / market / corporate; ensures the department proactively collaborates with other departments within the organization; and provides strategic / tactical support to region / market leaders to reach targets.

• Provide timely, accurate comprehensive and transparent financial reporting including, but not limited to, operating statements, trend reports and key business reports as needed to region / market and corporate leadership
• Assist growth and business development opportunities in existing / additional markets; work with appropriate region / market leadership to ensure reasonable assumptions are made around premium and claims for new markets or products
• Provide strategic support to region / market / Senior leaders to establish / reach targets
• Work with region / market leaders to prepare / present Monthly / Quarterly Business Review documents
• Ability to act with diplomacy and sensitivity to drive favorable resolution to internal and external issues
• Understand reimbursement methodologies impacting market products
• Support monthly close process by providing journal entries, accruals and supporting analysis as needed; have region / market specific knowledge of trends / drivers to influence IBNR models.
• Drive QAI plan for region / market; responsible for coordinating with market / work stream leaders to identify, implement and measure QAI initiatives to exceed targets
• Coordinate with department leaders on rate advocacy, revenue maximization efforts (risk adjustment and quality initiatives) and regarding pricing of Medicare, marketplace and other products as appropriate
• Responsible for cost reports and other regulatory filing requirements, interact with regulatory agencies as needed
• Support the annual budget and monthly / quarterly forecasting process for applicable region / market; provide necessary region / market specific data to ensure assumptions are reasonable
• Support the strategic planning process by providing long term financial projections reflecting the assumptions outlined in the strategic plan
• Provides insight into the risk sensitivity associated with the current and future business drivers
• Coordinate and support independent financial accounting audits and other regulatory financial related audits
• Utilize ad hoc and trending analysis - both proactively and as requested to identify drivers and mitigating QAI opportunities; modeling to support market specific contracting and enhancement initiatives; lead trend discussions with region / market leaders
• 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

• Bachelor's Degree in accounting, finance or related field or equivalent years of relevant work experience is required
• Master of Business Administration (MBA) or equivalent graduate degree is preferred
• A minimum of seven (7) years of experience in accounting / finance is required
• Previous senior level management experience is required
• Managed care or healthcare experience is preferred

• Familiar with variety of financial analysis concepts, practices and procedures
• Relies on extensive experienced 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 and provide insight and guidance to region / market leadership as well as Executive leadership regarding financial and business matters.
• Ability to lead the region / market finance function as well as interact with external partners (including Regulators, Actuaries, providers and peer MCO's)
• Ability to multitask and demonstrate flexibility in supporting several market leaders / business areas simultaneously
• Ability to lead and direct the work of others…