Summary:
Partner with both Commercial and Government segment leadership to guide and drive business regarding strategic initiatives from concept through implementation and to a mature operation. Plan, monitor, evaluate and develop EmblemHealth’s financial and business strategy in collaboration with segment leaders with an emphasis on bottom line performance. Support the EmblemHealth executive team with analysis of key financial and operational metrics to drive accountability and facilitate effective decision making across the organization. Partner with VP Finance to develop financial analysis, planning, budgeting, and financial reporting capabilities that support both the enterprise and the segment supported.Responsibilities:
Present monthly financial results, projections, and plan in coordination with Pricing and Medical Economics team to executive leaders inclusive of metric-based drivers, actionable opportunities, and risk/opportunities. Present and provide supplemental reporting on membership, underwriting case renewals, and administrative cost allocations. Track and report follow-up status of outcomes of actionable opportunities as part of monthly close meetings. Partner with operations team inclusive of Network, Clinical, Claims, Medical Economics, and IT. Support Product Leaders in the development of strategies to drive growth and profitability and in ensuring resources are effectively deployed to meet these strategic objectives. Act as financial conscience balancing risk management with finding a path to achieve business goals. Participate in and influence underwriting case renewals, ACA pricing submission, and Medicare product design to ensure target margins are achieved. Work to align performance across pricing, underwriting, product, and functional areas to ensure achievement of profitability targets. Support a buyer/ supplier review of administrative expense and capital projects to ensure that services / initiatives deliver align with value points of the market and deliver ROI.Education, Training, Licenses, Certifications
• Bachelor's Degree, preferably in Actuarial Science/Mathematics/Finance/Economics or a related field
• CPA, MBA or FSA preferred
Relevant Work Experience, Knowledge, Skills, and Abilities
• 10 – 12+ years of relevant, professional work experience. (R)
• Experience in healthcare finance roles (Pricing, Reserving, Medical Economics, or Financial Planning & Analysis). (R)
• 5 – 10 years of demonstrated progressive growth and successful leadership experience. (R)
• Proven track record of business partner interactions that lead to shaping strategy and achieving goals. (R)
• Ability to serve as a trusted partner to enable growth, drive efficiencies and earnings across a matrix environment. (R)
• Strong analytical skills with solid foundation in mathematical and statistical techniques. (R)
• Demonstrated ability to produce clear and concise financial forecasting and analysis. (R)
• Proficient in MS Office (Word, Excel, PowerPoint, Outlook, etc.) (R)
• Ability to seamlessly partner with senior levels of leadership. (R)
• Excellent communication skills (verbal, written, interpersonal). (R)
• Strong, independent decision-making ability and negotiation skills. (R)
• PeopleSoft, Hyperion, Cognos, Tableau experience (or equivalent platforms). (R)
• Understanding of Statutory reporting. (R)