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Director, Finance(Must Live in Nevada)

CareSource, Nevada, IA, United States


Director, Finance – Market provides financial oversight, leadership and support to the market/corporate and ensures the department proactively collaborates with and provides support for analyses being conducted by areas outside the Finance Department.

Essential Functions:

  • Provide timely, accurate comprehensive and transparent financial reporting including, but not limited to, operating statements, trend reports and key business reports as needed to market and corporate leadership
  • Responsible for input and review of market finance IBNR models and understanding market cost drivers/trends
  • Understand reimbursement methodologies impacting market products
  • Support monthly close process by providing journal entries, accruals and supporting analysis as needed. Maintain and distribute the BTL accruals to appropriate teams.
  • Responsible for coordinating with market/work stream leaders to identify, implement and measure QAI initiatives to exceed targets
  • Support Market’s APM, VBR, ACO, and other delegated arrangement strategies
  • Coordinate with actuarial teams on rate advocacy
  • Coordinate/liaison revenue maximization efforts (risk adjustment and quality initiatives) between the risk adjustment team, market Contracting/Health Partners teams, and providers
  • Participate in pricing strategy of marketplace and other products as appropriate
  • Review cost reports and other regulatory filing requirements, interact with regulatory agencies as needed
  • Support the annual budget and monthly/quarterly forecasting process for applicable market by providing assumptions, inputs, and review of all market financials
  • Coordinate, review and provide feedback to market on their annual admin budget (Market President rollup)
  • Provides insight into the risk sensitivity associated with the current and future business drivers
  • Support independent financial accounting audits and other regulatory financial related audits
  • Perform ad hoc and trending analysis – both proactively and as requested; modeling to support market specific contracting and enhancement initiatives
  • Responsible for management of departmental staff and expense budget
  • Responsible for making staffing decisions
  • Develop, implement, and modify processes to ensure efficiency and effectiveness
  • Assess internal controls and make appropriate changes to ensure compliance with MAR, regulatory and other organization requirements
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s Degree in accounting, finance or related field or equivalent years of relevant work experience is required
  • Master of Business Administration (MBA) or equivalent graduate degree is preferred
  • A minimum of seven (7) years of experience in accounting/finance, to include a minimum of three (3) years of management experience, is required
  • Managed care or healthcare experience is preferred

Competencies, Knowledge and Skills:

  • Familiar with variety of financial analysis concepts, practices and procedures
  • Relies on extensive experience and judgment to plan and accomplish goals
  • Familiar with variety of accounting concepts, practices and procedures
  • Intermediate proficiency level with Microsoft Office
  • Ability to interact with all levels of management, as wells as external audit management
  • Ability to multitask and demonstrate flexibility in supporting several market leaders/business areas simultaneously
  • Ability to lead and direct the work of others including the development, motivation and rewarding of staff
  • Knowledgeable of internal control framework
  • Critical listening and thinking skills analytical skills
  • Detail-oriented

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

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