This job oversees finance activities for the accounting, analysis, and internal & external financial reporting of revenue, accounts receivable, claim activities, general and administrative expenses, investments, taxes and related processes of Gateway Health Plan. The incumbent will be the business owner of certain systems and data repositories designed to facilitate the accounting, analysis and reporting of these transactions. Assumed responsibility for system development and enhancements for internal and external customer processes.
The incumbent directs the controls and activities required to ensure the timely, efficient and accurate accounting and reporting of these transactions in accordance with applicable accounting principles. Performs various leadership and review functions, as necessary. Directs department approach for large- scale multi-functional corporate initiatives impacting the revenue, claim processes, general and administrative expenses such as system or business migrations, company integrations, new product offerings etc. Leads projects to streamline/automate in order to gain efficiencies within the revenue, claims accounting, general and administrative expenses, analysis and reporting processes, and manage relationships with various internal Departments integral to these processes including Membership, Billing, Actuarial, Cash Processing, Operations, Financial Planning and Analysis, and Financial Reporting and external customers using the Organization's Platform.
- Communicate effectively.
- Direct and monitor the financial activities of the revenue, accounts receivable, claim processes, general and administrative expenses, investments, and taxes as well as properly train, mentor and develop the staff.
- Coordinate with other departments, locations, and divisions items critical for department processes.
- Communicate with other departments and/or outside agencies to address information or analysis requests for internal and external customers. (e.g. external CPA Firm, CMS auditors, Insurance Department Regulators, etc.).
- Oversee the financial accounting, analysis, and reporting of the Organization’s revenue, accounts receivable, and claim activities; general and administrative expenses, investments, and taxes.
- Accountable for revenue, accounts receivable, claim, general and administrative expenses, investments, and taxes and related accounts on the Organization's/subsidiary general ledgers. This includes but is not limited to active monitoring/review of the general ledger activity, analysis and investigation of fluctuations, trends and account balances.
- Responsible for providing support for the proper recording and maintenance of these financial transactions in accordance with GAAP and statutory (SSAP) accounting principles. This includes determining the proper accounting treatment for these transactions which may occur on a routine or non routine basis and the implementation of new GAAP/SSAP guidance as applicable.
- Business owner of certain systems and data repositories designed to facilitate the accounting, analysis and reporting of these transactions.
- Responsible for system development and enhancements for internal and external customer processes.
- Establish and direct the procedures and controls required to ensure effective internal control critical for the timely, accurate and efficient accounting and reporting of assigned processes including processes performed for external customers subject to SSAE 16.
- Direct the activities, procedures and controls required to ensure the timely, efficient and accurate accounting and reporting of these transactions. Meet MAR control requirements.
- Responsible for ensuring that appropriate analysis occurs on all related activity, to ensure accuracy of the accounting records.
- Provide management guidance in developing and implementing methods, policies and internal control processes used in the department.
- Responsible for providing direction and guidance on accounting and reporting related matters to Department staff.
- Maintain a strong knowledge of the Organization’s financial and operational systems including but not limited to billing, revenue estimation, claims, general and administrative expenses, investments, taxes, supporting source systems and general ledger including how these systems interact with each other during day to day operations and monthly reporting processes.
- Assign department responsibilities that maintain the efficiency and effectiveness of departmental processes but also that challenge staff and develop them professionally.
- Manage corporate initiatives such as system or business migrations or enhancements, new product offerings, company integrations etc. impacting department processes. Lead staff to develop or enhance current processes to accommodate.
- Lead the development and implementation of projects to re-engineer/automate current processes to increase efficiency and effectiveness of accounting, reconciling, balancing and analysis procedures. Maximize gains from budget dollars allocated to such projects.
- Other duties as assigned or requested.
- Bachelor’s Degree in accounting, finance, or a business related field
- 7 years of experience in Finance, Accounting, and/or Financial Analysis
- 5 years of experience managing staff and/or projects of varying size and complexity
- 5 years of experience designing and implementing financial systems / new financial processes
- 3 years of experience utilizing an automated general ledger and consolidation package and/or various other data repositories
- 6-8 years of experience in health insurance industry accounting practices particularly with respect to accounting, reporting and analysis of revenues, claims, general and administrative expenses, investments, and taxes.
- 6-8 years of public accounting experience, preferably within the insurance or healthcare industry
- 8 years of experience managing staff and/or projects of varying size and complexity
SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?
Is Travel Required?
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.
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