Chief Financial Officer - Prominence Health Plan

Responsibilities

As Chief Financial Officer (CFO) of Prominence Health Plan, you will oversee the financial activities of the Plan, including accounting, financial reporting, regulatory and statutory accounting, planning and analysis, budgeting, actuarial services, underwriting and financial pricing decisions, IBNR reserve preparation, premium billing and collection, and accounts payable. You will also coordinate the annual reinsurance program, partner with the CEO and senior executives on strategic initiatives, and report directly to the CEO.

• Leads and manages accounting, financial reporting, regulatory reporting, actuarial services, premium billing, and accounts payable.
• Supervises the Health Plan financial reporting process.
• Oversees the preparation of reports outlining the Health Plan’s financial position and operating profit and loss statement.
• Ensures timely filing of federal and state financial reports.
• Collaborates with UHS’s corporate financial services on all Health Plan financial matters.
• Aligns Prominence Health Plan infrastructure development with UHS corporate value‑based care strategy.
• Manages relationships with outsourced vendors, partners, and key provider groups.
• Initiates and drives activities to advance quality, improve member, provider, and employee satisfaction, optimize revenue, reduce expenses, and increase productivity.
• Oversees budgets for each functional area, reviews monthly performance, and ensures objectives are met.
• Promotes data‑driven decision making through a robust analytics strategy.
• Represents Prominence Health Plan and UHS strategic initiatives, and serves as backup to the CEO when needed.
• Executes and implements strategic goals by interfacing with and ensuring connectivity across leadership.
• Develops initiatives to contribute to strategic and profitable growth.
• Performs additional duties as necessary.

• Master’s degree required, a minimum of 8‑10 years of experience.
• Travel:
  Ability and flexibility to travel to current and future markets – 10%+ travel.

• Health Plan Financial reporting, accounting, and analytics
  • GAAP, Statutory, and Management reporting.
  • AP/AR oversight.
  • IBNR.
  • Actuarial services.
  • Cash flow management.
• Annual budgeting and strategic financial planning.
• M&A Activity, Investor Relations, Joint Venture Investments.
• Lines of Business
  • Medicare Advantage, Commercial, Self‑Funded/ASO.
  • Extensive understanding of Medicare Advantage and federal program financials.
  • Significant experience with Bid Submission.
• Medicare Advantage Risk Adjustment & STARS.
• Commercial business underwriting.
• RBC – Risk Based Capital.
• Traditional payer contracting, value‑based contracting including risk and capitation.
• Reinsurance/Stop loss strategies.
• Experience with other federal Medicare programs – ACO models, MSSP programs, Direct contracting, PBCI, etc.

• Team leader and individual contributor.
• Start‑up culture managed by a Fortune 300 entity.
• Strategic perspective on the industry with ability to be hands‑on and comfortable with the details.
• Passion for execution.
• Nimble organization with decision‑making power and limited politics.
• Passion for driving healthcare initiatives and change under a broader population health, value‑based strategy.
• Significant experience traversing deep financial details and activities and summarizing to strategic conclusions for corporate oversight and execution.

• Ability to effectively communicate in English, both verbally and in writing.
• Microsoft Office experience.
• Strategic but practical thinker that can take concepts from initial stage through implementation to administration.
• Excellent communicator who is equally comfortable with external and internal stakeholders.
• Demonstrated ability to build a highly functioning team and mentor direct reports.
• Experience with commercial, self‑funded, and Medicare Advantage products.
• Proven ability to foster collaboration between divergent stakeholders.
• High degree of credibility with key stakeholders based on past accomplishments.
• Experience negotiating complex provider reimbursement arrangements and third‑party contracts.
• Adept at managing outsourced vendor relationships in…