Description

JOB SUMMARY

This job is responsible for oversight of the financial operations, direct operating expenses, and the growth-related finance needs of Government Segment Finance & Growth 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.

This role will build economic models and supporting processes related to the government segment growth initiatives (inclusive of new market entry, partnerships and inorganic growth), and partner with senior leadership to identify impact.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but are not limited to : involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
• Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary;

may have budgetary responsibility and authority.

Direct growth-related economic models for the Government Segment and communicate results of strategic impact analyses to senior management.

These growth economic models include scenario modelling and other integrated economic exercises that arise around potential changes in reimbursement rates, member volumes, or other financial metrics associated with strategic initiatives and the financial plan.

The incumbent is responsible for coordinating the completion of the strategic scenarios, analyzing the results, suggesting alternative approaches and presenting them to varying levels of senior management for approval.

These economic models, specifically the scenario modeling, serve as an input to the government segment’s strategic and financial plan.

Functions as a member of the team responsible for developing vision and strategy. Provides detailed guidance on the preparation of all financial components of the strategic plans across the business segment.

Oversees communication of strategy and vision to management and staff and to representatives of the company. Responsible for the development of repeatable and standardized financial processes for assessing, decisioning and implementation of segment growth opportunities including the development of a growth playbook and oversight of the financial components of the implementation of growth opportunities

Leads 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.

Provides oversight of the business segments initiatives, ensuring that initiative business cases are thoroughly documented and that measurable success criteria are contemplated in current and multi-year budgets, projections, etc.

• Oversees the detailed, multi-year earnings improvement initiatives under the direct and indirect control of the segment leadership, including measurable initiatives across all Profit & Loss (P&L) categories.
• Partners with actuarial functions, enabling effective product pricing, in-year claim analysis, and incurred but not recorded reserve decision making.
• Oversees compliance matters including product filings, resolution of regulatory issues, responses to regulatory inquires, for a variety of products and programs marketed across the United States.

Provides counseling / advice with respect to regulatory developments in the external environment, product development issues, and the interpretation and administration of Commercial Markets products.

Prepare and present financial (business case) analysis of government segment initiatives to senior management for use in the strategic planning process and daily management of the business activities of the segment.

This accountability involves working with the business owners (SVPs and VPs) of the strategic initiatives to obtain the data necessary to complete analysis of expenditures, cash flows, and return and risk to the segment associated with each initiative and presenting findings.

Also prepare postmortem analysis on launched initiatives in order to evaluate performance in partnership with Treasury and related business units.

Other duties as assigned or requested.

EDUCATION

Required

Substitutions

6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

Master's degree Business Administration, Finance, Accounting or other related field.

LICENSE / CERTIFICATION

Required

CPA (Certified Public Accountant)

Preferred

None

EXPERIENCE

Required

• 7 years of progressive management or leadership experience
• 7 Years of finance or accounting experience

Preferred

Healthcare payer sector experience

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 organizational and analytical skills.
• Ability to work in a matrixed organization / environment.

Language Requirement (other than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS, AND WORKING CONDITIONS

Position Type

Office Based

Teaches / trains others regularly

Does Not Apply

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products / services (sales employees)

Never

Physical work site required

Lifting : up to 10 pounds

Constantly

Lifting : 10 to 25 pounds

Occasionally

Lifting : 25 to 50 pounds

Rarely

Pay Range Minimum : $126,400.00

$126,400.00

Pay Range Maximum : $233,700.00

$233,700.00

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, age, 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, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()

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Last updated : 2024-07-04