Associate Vice President, Finance - Emory Health Plan

Transform Healthcare Finance At Scale Emory Health Plan seeks an exceptional finance leader to architect and execute a $500M growth strategy, scaling operations from $800M to $1.3B over three years. A rare opportunity to lead transformational change at one of the nation's premier academic health plans serving 63,000 lives. As Associate Vice President of Finance reporting directly to the President of the Emory Health Plan, you'll drive financial strategy, build scalable infrastructure, and shape the future of healthcare delivery during the most dynamic period in the plan's 30+ year history. Your leadership will directly impact healthcare affordability, value-based care innovation, and population health for the entire Emory community. Strategic Financial Leadership ($800M ? $1.3B) Architect and execute multi-year financial strategy supporting 62% growth while maintaining fiscal discipline Lead annual budgeting, forecasting, and scenario planning for $1.3B health plan operations Serve as principal financial advisor to President and governance committee on sustainability, benefit design, and strategic investments Design pricing strategies, rate-setting methodology, and contribution structures balancing affordability with financial integrity Present quarterly to EHP Governance Committee and semi-annually to University Board Risk Management & Actuarial Oversight Restructure stop-loss insurance program for $1.3B scale (specific and aggregate coverages) Manage $80-100M reserve fund with sophisticated incurred but not reported (IBNR) calculations and actuarial validation Oversee relationships with external actuaries for valuations, trends, and strategic consulting Conduct stress testing for catastrophic scenarios including pandemics, high-cost therapies, and market disruptions Evaluate captive insurance and risk retention strategies appropriate for $1B+ operations Analytics, Utilization & Value-Based Care Scale analytics infrastructure from 20M to 35-40M annual claims with advanced predictive modeling and machine learning Perform deep-dive utilization analysis identifying cost drivers, trend decomposition, and optimization opportunities Expand value-based care arrangements from current baseline to $300-400M (30-35% of spend) Design and negotiate shared savings/risk contracts with providers including capitation, bundled payments, and ACO arrangements Deliver ROI on care management programs and clinical interventions with measurable outcomes Vendor Management & Cost Optimization Lead negotiations with TPA, PBM, stop-loss carriers, and specialty vendors managing $50M+ administrative spend Generate $30-50M annual savings (3-5% of budget) through strategic contracting, plan design, and operational improvements Evaluate and implement innovative cost strategies: reference-based pricing, centers of excellence, direct contracting, specialty drug optimization Establish rigorous SLAs, performance guarantees, and vendor scorecarding for accountability Regulatory Compliance & Governance Ensure full compliance with ERISA, HIPAA, ACA, CAA transparency requirements, Mental Health Parity Act, and all self-funded plan regulations Oversee Form 5500 preparation, PCORI fees, Medicare Part D reporting, and regulatory filings Lead audit preparedness and coordinate with external auditors, DOL, and regulatory agencies Develop compliance management system with controls, documentation, and audit trails Transformation & Innovation Drive adoption of emerging technologies: AI/ML for predictive analytics, RPA for automation, cloud-based financial systems Lead major VBC transformation initiatives Champion continuous improvement using Lean/Six Sigma to optimize operations for scale Build data-driven culture with self-service analytics, real-time dashboards, and advanced modeling capabilities What You Bring Required Experience Bachelor's degree in Finance, Accounting, Health Care Administration or related field and 10 years of progressive financial leadership experience, including direct experience with self-funded health plans, academic institutions or integrated health systems. MBA, MHA, MPH or other related master's degree strongly preferred. CPA, CMA, FSA or ASA strongly preferred. Progressive healthcare finance leadership with 10+ years managing self-funded health plans (50,000+ lives) or health plans with $500M+ annual spend Proven track record leading through significant growth or transformation (50%+ revenue/membership increase within 3-5 years) Deep expertise with academic medical centers, integrated health systems, Fortune 500 self-insured employers, or managed care organizations Direct experience negotiating and managing stop-loss/reinsurance programs for $500M+ plans Demonstrated success scaling value-based care arrangements to $200M+ with measurable financial outcomes Executive presence with board and C-suite presentation experience Technical Mastery Actuarial proficiency: IBNR calculations, reserve management, trend analysis, credibility theory for large risk pools Claims analytics: Advanced utilization analysis, predictive modeling, risk stratification across 20M+ annual claims VBC contracting: Shared savings/risk design, bundled payments, capitation, quality metrics, financial reconciliation Financial modeling: Multi-year forecasting, scenario planning, growth modeling, contribution strategies Data & analytics: SQL, Tableau/Power BI, statistical analysis, machine learning applications Regulatory expertise: ERISA, HIPAA, ACA, CAA, Mental Health Parity, Form 5500, self-funded plan compliance Leadership Capabilities Strategic thinker who translates complex financial concepts into actionable business strategies Exceptional communicator demonstrating leadership and cross-functional partnerships Change agent who leads transformation with resilience, adaptability, and coalition-building Team developer who builds high-performing, diverse teams and cultivates talent Systems thinker who sees interconnections in complex organizations and solves root causes Mission-driven leader passionate about healthcare improvement and population health Key Performance Indicators Budget accuracy Medical cost trend 200-300 bps below national benchmarks $30-50M annual cost savings (3-5% of budget) through optimization VBC portfolio scaled to $300-400M (30-35% of spend) with positive ROI Achieve $1.3B growth target within 3-year timeline Clean audit opinions with zero regulatory findings Stakeholder satisfaction scores 4.7+/5.0 (President, governance, HR, clinical partners) Team engagement in top quartile with Why Emory Health Plan? Transformational Impact Lead a $500M growth initiative - a once-in-a-career opportunity at this scale Shape the future of one of the Southeast's largest academic medical center health plans Drive innovation in value-based care, payment reform, and healthcare delivery Create lasting impact on healthcare affordability and access for 63,000+ lives Career Acceleration Highly visible role reporting directly to President with board exposure Platform for thought leadership through publications, speaking, and industry recognition Unparalleled scope and complexity managing $1.3B health plan through growth period

Created: 2026-03-04