Director Finance

Your career starts now. We''re looking for the next generation of health care leaders.At AmeriHealth Caritas, we''re passionate about helping people get care, stay well and build healthy communities. As one of the nation''s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we''d like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at Responsibilities:The Director, Finance is responsible for the oversight of all financial activities for the plan including but not limited to financial statements, active participation in the annual budget process and reconciliation of operational staff and also provides strategic director for Provider Network value based contracting across the Plan by partnering with the Plan''s Directors and managers of PNM. The director is a critical member of management who provides membership, financial results and support during the budgeting process and serves as a subject matter expert for VBC for internal Plan counterparts and members of the Plan''s provider network community. The director is the main point of contact and develops partnerships with other departments including Implementations, Sales, Account Management, Informatics, Customer Service, Provider Network Management and corporate accounting regarding membership. The director is required to interface with all levels of management and outside vendors in order to resolve funding issues, accounts receivable balances and any finance related issues. In partnership with each of the Plan''s Directors and Managers of Provider Network Management, responsible for all assigned hospital, physician and physician extender value based program development and management, formulating and implementing alternative reimbursement methodologies for various provider types that ensure the financial performance of the network. Financial Management Oversee key financial aspects of operational activities (Revenue, Expenses, Management Fee & Intercompany).Ensure accurate and timely processing of cash receipts (accounts receivable & network administration fees).Directs the individual and consolidated reporting of results for cost centers.Develop budget projections (forecasts, reforecast) and monitors performance monthly. Maintain and review Operating Revenue models for new business and strategic planning needs.Responsible for leading the annual operating budget plans.Validate and ensure all costs that are associated with the family of companies are passed onto the plans.Provide financial oversight to ensure contract compliance with suppliers.Ensure accurate and timely invoicing of clients for service performed by plan.Provide financial compliance and oversight for contracts between plan and outside vendors.Act as a liaison with internal and external business partners on all financial matters.Review and provide approval for claims processor payment and dispute costs as necessary. Market Value Contracting ProgramsProviding analytical support for value-based programs, including independently monitoring/measuring the performance the initiatives by leveraging utilization, financial, clinical, and benchmark data from multiple internal and external sources. Performing analysis, summarizing results, and over-seeing value based payments while adhering to established standards and processes.Developing short and long term value based strategy for AmeriHealth Caritas District of Columbia.Collaborates with internal partners (IS, PMO, Business) to improve our practices and ensure they are integrated with the broader community.Responsible for all assigned hospital, physician and physician extender value based program development and pliance with value based contracting pricing guidelines.Ensures provider value based contracting is consistent with program payment methodologies.Maintains familiarity with State Medicaid fee schedules and analyzes comparable value based programs from other payors.Formulates and implements alternative reimbursement methodologies for various provider types that ensure the financial performance of the network. Administration Hire, train, coach and evaluate performance of direct reports.Assists Account Executives with planning, implementing, and monitoring value based programs.Ensures the achievement of financial, quality, and clinical objectives through accomplishment of value based provider initiatives.Ensure all membership and quarterly reporting is accurate and distributed to management.Provide ACFC corporate with organizational wide cost allocation to support business municate with all departments managers on span of control, staff and cost center expenses.Develop and maintain a process to provide reliable critical metrics to management.Hire, train, coach and evaluate performance of direct reports.Education/ Experience: Bachelor''s Degree Required.Master''s Degree Preferred.5 to 10 years Finance, Accounting, Medical Economics, Informatics or medical management and analytic reports.Five or more years management experience required, managed care environment preferred.Other Skills: PeopleSoft Financials, Hyperion, Essbase, Microsoft Office, Access. 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Created: 2021-11-29