What are the responsibilities and job description for the Senior Finance Manager position at Storm3?
You must be coming from a Health Insurance provider (HMO, ACA, etc.)
Budget and forecasting – HMOs
Lead annual budgeting and planning process
Manage cash flow and forecasting; direct all financial, project-based, and departmental accounting
Monitor HMO capital levels on an individual company and consolidated level and escalate issues based on predefined internal metrics (i.e RBC, economic capital, etc)
Monitor investments against HMO’s investment policy and internal capital levels
Lead the data analysis efforts to identify business opportunities and issues with data quality, completeness, consistency, and accuracy, mainly on the Revenue (premium) analysis and medical costs data
Statutory Health insurance and GAAP reporting – Identify areas for 3rd party support and execution
Ensure compliance with regulatory reporting requirements, including researching existing and new legislation, consulting with outside advisors, and filing financial reports
Oversee accounts, ledgers, and reporting systems, ensuring compliance with appropriate standards and regulatory requirements
Prepare and present financial reports and risk analysis
Key liaison to external auditors and annual audit support
Shared services chargebacks, transfer pricing, and Intercompany transactions
Revenue (premiums) and medical costs recognition
Internal financial controls and financial stability
Assist management in the development, implementation and monitoring of internal financial controls and corporate policies to maintain financial stability
Vendor and project management
Conduct market research and identify prospective vendors to address organizational requirements
Lead negotiations and implementation with vendors to address the functional requirements of an HMO
Work in collaboration with the team to identify opportunities for business process improvement and support the implementation of such changes
Lead the actuarial process with the 3rd party actuarial consultant for premium pricing, reserves, and proformas
Work with executive management and 3rd party actuarial team on reinsurance programs, structures, marketing, contract negotiation, etc. (stop loss protection)
Hands-on with TPA management, Research, Analysis and Reporting
Develop organization financial KPIs for HMO operations and performance and work in concert with the internal technical resources to operationalize a KPI dashboard
Research, evaluate, and provide guidance on regulatory, compliance, and product design issues in partnership with the team
Medical claims payments and analysis – and identification of opportunities for savings and efficiencies
Risk adjustment
Oversee all risk adjustment processes, including developing workflows, tracking deadlines, and managing vendor contracts
Work with business leaders and clinical teams to improve clinical documentation and claims submission processes
Create work plans and ensure timely completion of projects
Lead efforts to enhance coding, claims processing, and overall revenue cycle management
Data Analysis : Evaluate risk adjustment strategies, perform root cause analysis, and develop interventions to improve outcomes
Manage relationships with vendors supporting coding, billing, and collections
Lead audit strategies and ensure compliance with regulatory requirements
Build and develop a high-performing accounting team over time that might include a combination of internal and external resources
Qualifications
Educational Requirements :
A bachelor’s degree in finance, accounting, economics, or a related field is required
A CPA, CFA, or ACCA would be a strong advantage
An MBA or a master's degree in finance or accounting is an advantage
Experience :
At least 7-10 years of experience in finance, with a significant portion within the health insurance industry
Deep understanding of the health insurance sector (specifically ACA, small and large groups, ICHRA), including regulatory requirements and financial management practices – must have
Skills :
Ability to develop and implement financial strategies that align with the organization's goals
Strong analytical and problem-solving skills, with proficiency in financial modeling and data analysis
Proven leadership and team management skills, with the ability to mentor and develop finance teams
Excellent communication and interpersonal skills to effectively collaborate with senior management and other stakeholders
In-depth knowledge of financial regulations and risk management strategies
Familiarity with platforms such as NetSuite (ERP tool), Zuora, and PaymentTech is an advantage
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