Senior Director - Medicaid Finance

Job ID: J121075
Company: Gateway Health Plan
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Apr 18, 2018

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Description

JOB SUMMARY

This job conducts oversight of the financial operations of a business segment within the company, and support the direct operating expense oversight of the department.  Appraises operating results in terms of costs, budgets, operational policies, trends and increased profit opportunities.  Partners with segment and matrix partner leaders to drive achievement of current year and multi-year financial commitments.

ESSENTIAL RESPONSIBILITIES

  • Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
  • 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.
  • Conduct oversight of detailed, multi-year earnings improvement initiatives under the direct and indirect control of the segment leadership, including measurable initiatives across P&L categories.
  • Function as member of the team responsible for developing vision and strategy.  
  • Provide detailed guidance on the preparation of all financial components of the strategic plans across the business segment.  
  • Oversee communication of strategy and vision to management and staff and to representatives of the company.  
  • Serve as a key liaison with key government leaders.  Serves on Medicaid State Finance Committee.
  • Partner with actuarial functions, enabling effective product pricing, in-year claim analysis, and incurred by not recorded reserve decision making.
  • Oversee compliance matters including product filings, resolution of regulatory issues, responses to regulatory inquiries, for a variety of products and programs marketed across the United States.  
  • Provide counseling/advice with respect to regulatory developments in the external environment, product development issues, and the interpretation and administration of commercial markets products.
  • Accountable for activities required to maintain financial records, the preparation of financial statements, and the preparation of statutory reports for submission to the Department of Health Services (“DHS”).
  • Lead the business segment department operating expense oversight, including maintenance of budget development processes and assessment of operating effectiveness with respect to current and multi-year financial performance targets.
  • Conduct oversight of the business segments initiatives, ensuring that the initiative business cases are thoroughly documented and that measurable success criteria are contemplated in current and multi-year budgets, projections, etc.
  • Other duties as assigned or requested.


QUALIFICATIONS

Minimum

  • Bachelor’s Degree in Finance or Accounting or other related field
  • 10 years of progressive management experience in finance or accounting in the health care payer sector

Substitutions

  • None

Preferred

  • MBA
  • Certified Public Account (“CPA”)


Skills

  • Ability to analyze financial results and to comprehend complex rating structures impacting financial results and used for financial forecasting
  • Effectively interact with all levels of management, which includes strong written and verbal communication skills and the ability to concisely explain financial principles and practices
  • Must be detail-oriented and possess strong organization and analytical skills
  • Ability to work in a matrixed organization/environment


SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?   

Yes 

WORK ENVIRONMENT
Is Travel Required?  

Yes  

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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