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Finance Director-Government Business Division, California
Medicaid (Advanced Cost of Care)-PS34865 Location: Glendale, CA
Job Family: Accounting/Finance/Auditing
Req #: PS34865
Date Posted: Jul 24, 2020
This position may startby working at home. Must be onsite
in the Glendale or Thousand Oaks Officewhen offices reopen.
Responsible for financial leadership, decision support,
andstrategic consultation to the California Medicaid Health Plan
leadership team.Directs health plan financial analysis, cost of
care analytics, trend analysis,financial reporting, financial
operations, and cost and budget management andallocation in a
Health Plan with an assigned product or portfolio, which mayinclude
specialty products and/or provider contracting arrangements that
carryfinancial risk to the plan P&L, serves as legislative
consultant with statepartners on financial/reimbursement policy and
Primary duties may include, but are not limited to:
Directs market leadership for P&L andSG&A budget;
operates as a financial liaison to state partners; leads
ratesmanagement and negotiation including reserve development and
analytics; andleads the Medical Cost and RX Trend identification
and mitigation process withkey business partners including network
and clinical teams.
Maintains trends that are appropriate given
Reviews, analyzes, reports, and presentsfinancial results.
Provides decision support for business unit President andsenior
management teams’ operational and business goals.
Achieves Medical Cost and MLR targets set inplans and forecasts;
may ensure that provider network contracting effortsobtain the best
possible financial arrangements; may own the setting of
andachievement of Cost of Care targets; and achieves operating gain
targets set inbudgets and forecasts.
Directs Health Plan preparation of annualoperating/capital
budget and forecasts to provide seniorleadership with tools
necessary to maximize investment of resources.
Directs interface with regulatory and auditpersonnel and
technical consultants as required to ensure
Supporting the pricing actuaries on premium rateactions.
Representing the health plan at key state andprovider meetings;
oversees the processing and delivery of several majorprovider pass
thru payments; and is a key member of the CA leadership team.
Helping to support the plan president on settingand achieving
health plan goals.
Requires a BS/BA in Finance, Business Administration,
Economics or Accounting; 8-10 years of progressive financial
experience accounting,financial reporting, business analysis,
budgeting, forecasting, and strategicand tactical planning within a
health insurance/managed care environment;experience with complex
business environments including multiple entity andhighly regulated
situations; or any combination of education and experience,which
would provide an equivalent background.; MBA preferred.
Significantexperience working with shared savings arrangements is
stronglypreferred. Medicaid managed care experience
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