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Anthem, Inc. Finance Director-Government Business Division, Ohio Medicaid in Mason, Ohio

Description

SHIFT: Day Job

SCHEDULE: Full-time

The Government Business Division Finance Director is responsible for financial leadership, decision support, and strategic consultation to the leadership team in the Health Plan. This role directs health plan trend analysis, cost of care, financial reporting and analysis, financial operations, cost and budget management and administrative allocations in the Ohio Medicaid Health Plan, and serves as a key liaison and subject matter expert with our state customer on medical trends, financial/reimbursement policy, payment mechanisms and financial implications of program and benefit changes.

Primary duties may include, but are not limited to:

  • Health plan P&L owner along with plan president and other functional leaders.

  • Serves as key health plan leader providing financial and strategic insight to other health plan functional areas; operates as a liaison with state partners; leads reimbursement management and negotiation; owns the Medical Cost Trend, cost of care process for plan and mitigation initiatives; and reviews financial statements, reserve development and financial analytics.

  • Partners with pricing actuaries to ensure that premium reimbursement is adequate to cover medical trends, administrative expenses and profit.

  • Reviews, analyzes, and presents financial results to health plan and line of business leadership as well as the board of directors.

  • Provides decision support for health plan leadership team for operational and business goals.

  • Directs health )

  • Achieves Medical Cost, MLR and operational income targets set in forecasts; ensures that provider network contracting obtains optimal financial arrangements; co-develops the setting of Cost of Care (CoC) targets and is responsible for CoC execution.

  • Directly interfaces with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability.

Qualifications

  • Requires a BS/BA in Finance, Business Administration, or Accounting; 8-10 years of progressive financial experience with strategic and tactical planning, medical trend or business analytics, budgeting/forecasting, and accounting or financial reporting within a health insurance or managed care environment; experience with complex business environments and highly regulated situations; or any combination of education and experience, which would provide an equivalent background.

  • MBA preferred.

AnEqualOpportunityEmployer/Disability/Veteran REQNUMBER: PS39273-Mason-Mason

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