Gateway Health Plan
Job Description :
This job leads the Enterprise process to develop consolidated financial forecasts, provides periodic reporting to the Sr. Leadership and external stakeholders (e.g. PID, etc.), and works on strategic decision support analysis for the CFO and Leadership team. This includes overall understanding and research of the health care marketplace/industry. The incumbent establishes the Health Plan’s forecasting and budgeting, consistent with Executive Management’s goals and the changing business environment. As part of this responsibility, the incumbent interacts directly with the Management team (including the SVPs and CFO) providing information on how various courses of action impact costs, product costs and profitability. Provides support on a variety of health plan activities ranging from the analysis of ongoing operations to the pursuit of strategic initiatives such as technological investments or potential business consolidations.
- Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; manage budget for the FP&A function.
- Health Plan economic modeling. This involves working with the strategic planning area and each business area to understand their current business economics, the future proposed strategy of the businesses and the trade-offs among the business units that can be optimized to ensure the health plan meets its objectives and completing financial modeling to demonstrate the related outcomes. Included in this responsibility is the development of hypothesis related to the economic trade-offs and the financial modeling to prove or disprove the hypothesis.
- Capital planning for the health plan. This involves completing financial modeling to understand the current risk adjusted return on capital, to prepare scenarios involving varying allocations of capital and projecting the risk adjusted return on capital.
- Oversee the Health Plan budget and forecast process consistent with Executive Management’s goals and company plans. This involves working directly with the Sr. Director of FP&A and CFO to establish budget assumptions and an overall spending plan consistent with the company’s book of business and strategic plans. It also involves ensuring that the health plan budget process is completed in an efficient, accurate, and timely manner. This accountability requires the availability of a user-friendly system that facilitates efficient budget preparation and management reporting.
- Oversee and forecast expenses to products consistent with expense budgets and allocation methodologies. This involves the preparation of product cost forecasts based on approved spending and cost accounting methodologies for the forecast periods. This information and subsequent product analyses are used to support pricing activities and rate filings. The administrative forecasts are prepared at the level of detail required for product profitability analysis. Periodically, forecasts are updated to incorporate changes to input variables such as spending, enrollment, etc.
- Actual results are analyzed against forecast on a monthly basis.
- Provide expert finance support. This includes working in support of and with finance executive leadership and the strategic planning organization to investigate the financial elements of questions regarding the strategic direction of the enterprise.
- Other duties as assigned or requested.
- Bachelor’s Degree in Accounting, Business Administration/Management or Finance
- Master’s Degree in Business Administration/Management, Accounting, Economics or Finance and / or CPA
- 5-7 years in Finance and Accounting
- 5+ years of management experience, including 2 or more years’ experience managing high-level analysts
- 5+ years of experience constructing/analyzing financial statements from both a GAAP and Statutory perspective
- 3+ years of experience (written and oral) presenting financial results to executive audiences with varying levels of financial understanding
- 2-3+ years of experience working with actuarial concepts
- 5+ years working with financial concepts that are unique to the insurance industry, including risk-based capital and underwriting activity
- 3-5 years of direct client advisory roles (internal or external)
- 1-3 years in the Healthcare Industry (payer or provider setting)
LICENSES or CERTIFICATIONS
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