Vice President Finance

Vice President Finance

www.myrecruiting.biz, the premier source for specialized Accounting recruitment in Texas, Louisiana and the Gulf South, is currently seeking Vice President Finance for a Direct Hire opportunity in New Orleans, LA. Our client company has a long term growth plans for this Health Care firm and is seeking only the most talented and driven professional to join their team.

Summary:

The VP Finance (Plan) is responsible for owning, managing, and driving the budgeting, forecasting, and financial analysis functions of the health plan or region to ensure the achievement of membership, premium, medical expense, gross margin, and local SG&A goals on a quarterly and annual basis. Major activities owned by this position include the annual budget, quarterly forecasts, financial statement analysis and interpretation, ownership of the ACT process to maximize gross margin, and participation in the premium rate-setting process. The VP will work collaboratively with health plan and corporate management in all areas of responsibility to ensure the organization is focused on current results vs. budget, current financial performance trends, and the identification and execution of initiatives to properly manage revenue, medical, gross margin, and SG&A to plan.

Responsibilities:

· Own topline, medical expense, and local/direct SG&A portions of annual budget process & quarterly forecasts.

· Drive process with Plan leadership in conjunction with CEO/COO.

· Conduct/coordinate all analysis required for membership, premium yield, medical expense, and local/direct admin by product.

· Provide all required files to Home Office Finance departments within required timeframes.

· Provide updated topline and medical projections as needed by the Home Office due to material changes in the business environment (new membership, new product, new provider contract, etc.).

· On a monthly and quarterly basis, provide necessary information to Actuarial for the medical accruals including:

o Large cases not in claim experience

o Major contract changes not in claim experience

o Other utilization or unit cost events not in claim experience

· Full participation in monthly operational meetings, financial statement meetings, and medical accrual meetings.

· On a quarterly basis, provide all necessary information for the other known liabilities, including detailed analysis for auditor review, within required timelines of close process.

· On a monthly basis, analyze, interpret, and communicate financial statement and medical accrual results to plan leadership for the month, quarter-to-date, and year-to-date.

o Identify and explain all variances to budget/forecast.

o Identify trends & key drivers in revenue and medical and roll them into ACT process for action.

o Assess impact on quarterly and full year budget/forecast targets for topline, medical expenses, gross margin, HBR, and pre-tax/pre-corporate earnings.

· Own the ACT program and ensure its success for the health plan in achieving revenue, medical, and gross margin targets on a quarterly and annual basis according to budget/forecast.

· Conduct and manage all required analysis for the ACT program.

o Identify, assess, document, and monitor all opportunities to maximize revenue and manage medical expenses to budget/forecast through membership, premium rate, unit cost, utilization, and cost containment initiatives.

o Ensure 150% of gross margin gap to budget/forecast is explained at all times.

o Fully utilize process tools and methodologies in accordance with Corporate standards.


· Fully engage with other Plans and Home Office departments to identify, define, and use standard tools and analytical approaches, including use of common data sets. Interaction with Medical Finance, Finance, Medical Management, Claims, Cost Containment, Provider Service Operations, and Premium Reconciliation is expected.

· Participate and contribute to ?Best Practice? forums with other Plans and Home Office to share initiative successes, share lessoned learned, identify best practices across the company, and identify new initiatives not currently implemented at the Plan.

· Monitor monthly cost containment activity, including investigation and resolution of adverse changes in collection activity.

· Provide direction to Cost Containment Unit for additional expense savings opportunities not taken.

· Monitor monthly claims production, including investigation and resolution of adverse changes in production statistics and their impact on medical accrual estimates.

· Monitor monthly supplemental revenue collections such as Maternity kick payments, Newborn kick payment, and reimbursable drugs, including investigation and resolution of adverse changes in collection activity.

· Monitor, analyze, and report any variances for local and direct administration expenses.

· Identify and drive opportunities for savings with Plan leadership on a monthly basis.

· Work with Actuarial to understand key drivers of the premium development for each product.

· Identify and monitor the assumptions and issues in the rate methodology that drive financial success including trend, populations covered, benefits covered, unit cost assumptions, risk adjustment, birth rates, newborn enrollment rules, special populations (i.e. AIDS/HIV), utilization assumptions, and program changes.

· Communicate to key Plan leadership and ensure they understand the drivers of success underneath the premium rates.

· Monitor performance against quantifiable drivers of premium rates and resolve adverse variances as they arise

Qualifications:

Required: MBA or CPA.

Required: 12+ years Managed Care Finance, Accounting, or Actuarial experience in a leadership role in a health plan and at least 5 years leadership management experience.

Specific Technical Skills

Required: Proficient in Microsoft Windows environment including the Office suite of products, proficiency with database programs such as Microsoft Access, advanced skills in Microsoft Excel, advanced analytical skills, and excellent communication skills.

Preferred: Hyperion Pillar, SPSS or equivalent, SQL

If you are in search of a challenging position as Vice President Finance or know someone who would be interested in this, please contact Lee Youngblood at (832) 242-9408, or e-mail your resume to lee-resumes@myrecruiting.biz for confidential consideration.

Go online for more details on the Vice President Finance position, or visit our website http://www.myrecruiting.biz for more job offerings.
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McIntyre Youngblood Recruiting, LLC, www.myrecruiting.biz is an equal opportunity employer specializing in direct hire employment and temporary staffing of accounting, finance, legal, administrative and information technology (IT) professionals in Houston, Dallas and New Orleans. With 30 plus years of experience we are able to provide experienced candidates at all levels including management consulting. MYRecruiting is a certified Woman Owned Business Enterprise (WBE) and HUB qualified. McIntyre Youngblood Recruiting, LLC was named to Louisiana?s Top Business List for 2008 and 2011 by www.DiversityBusiness.com as a top emerging business.

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