Role Description The Director of Finance, Managed Care will assist the VP of Finance by acting as his primary backup in all functions related to financial operations, budget development, provider contracting, business analytics and planning functions. The VP of Finance will work side-by-side with the Director of Finance in all fiscal matters related to managing the $190 million managed care services budget. Qualifications - Bachelor's degree in finance, Business or Accounting (Required) - Master's Degree (Preferred) - 10 years Health care financial management experience with managed care (Preferred) - 5 years Finance leadership roles (Required) Requirements - Proficient in Microsoft Word, Excel and Outlook. - Analyze data, generate reports through Pivot tables, and excel spreadsheets. - Ability to extract data using a variety of commercially available tools including MS Excel, MS SQL tools, and learn new analytics tools such as Tableau, Power BI, etc. - Medicaid Managed Care of Health Plan Operations experience. - Monitor and report financial performance of provider and vendor contracts and ensure compliance with contracting guidelines. - Experience with department budgeting, financial reporting, and budget review. - Develops, secures approval of and administers a budget, including a capital budget. - Manages project execution to ensure adherence to budget, schedule, and scope. - Analyzes data to forecast and interpret potential trends in population health. - Extensive experience in major customer contracting involving integrated commercial organizations. - Excellent interpersonal and relationship management skills. - Excellent oral, written and presentation skills. - Proven ability to foster collaboration, value others' perspective and gain support and buy-in for organizational proposals. - Proven ability to drive and lead organization through significant change. - Proven success in managing growth of business operations. - A strong knowledge of strategic planning, data analytics, and management dashboard development. - Ability to apply data and analytics to solve complex, impactful problems. - Strong knowledge of business intelligence software and major enterprise systems. - CPA License Upon Hire (Preferred). Job Functions - Oversee all finance related activities for managed care entity including developing and monitoring progress against annual budget, identifying medical cost trends and participating in medical cost improvement initiatives. - Responsible for implementing CMS, DHCF, and DISB requirements related to medical loss ratio reporting, fiscal soundness reporting, audit assistance, and analysis of service utilization, drug utilization, and other cost trends. - Manage and monitor finance activities related to Master Services Agreement (MSA) with Children’s and the related division of responsibilities. - Lead rate-setting activities by coordinating activities with DHCF and its consulting actuary. - Provide insight and analysis with respect to provider contracting and data analytics activities particularly in the area of Value Based Purchasing (VBP). - Plan, develop, and prepare complex reimbursement models, including but not limited to value-based payment and reimbursement, population health management, risk, and capitation. - Review and analyze statistical, cost, and financial reports for complex payor contracts. - Conduct retrospective review of claims payment history (Lag Report, PM/PM Report). - Monitor the volume of monthly authorizations and provide projections on the potential financial impact. - Validate accuracy capitation revenue payments and reconcile with available sources. - Keep abreast of financial and regulatory matters affecting managed care services. - Lead establishment of organizational and departmental performance metrics. - Review monthly performance and financial results of the business unit and provide recommendations to senior management. - Serve as a member of various managed care services committees. - Regularly review historical operating results and proactively identify and analyze potential revenue enhancement and cost-saving opportunities. - Take lead in planning, review, and execution of annual year-end audits. - Responsible for special projects assigned to him/her by the VP of Finance. Organizational Accountabilities - Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence is achieved. - Innovates through improvement of care and/or efficiency of operational processes. - Creates a safe environment that encourages brainstorming, creativity and “out-of-the-box” thinking. - Proactively assumes responsibility and accountability for results to include management of organizational change. - Empowers staff in ensuring a culture of transparency, fairness, respect and excellence. - Encourages collaboration with team members based on trust, mutual respect, consistent visible support, and open and honest communication.

• Oversee daily accounting operations, including AP, AR, payroll, and general ledger • Prepare monthly, quarterly, and annual financial statements • Manage budgeting, forecasting, and cash flow planning • Ensure compliance with U.S. GAAP, tax regulations, and internal controls • Analyze financial performance and provide recommendations to management • Monitor operational costs, profitability, and key financial metrics • Coordinate audits and work with external accountants and financial institutions • Support executive leadership with financial planning and strategic decision-making

• Prepare, review, and report financial data • Supervise accounting staff • Review and prepare monthly journal entries and reconciliations • Review and approve accounts payable invoices and expense reports • Prepare financial reports and analysis for management • Monitor fixed asset accounts • Complete intercompany invoicing • Research complex accounting transactions and ensure compliance • Assist with audits and ensure compliance with laws and regulations • Document policies and procedures and recommend improvements • Mentor new and existing accounting staff

• Lead accounting relationships for a portfolio of clients • Build trusted advisor relationships with clients • Review and analyze financial statements • Serve as a high-level accounting resource for complex issues • Support and mentor bookkeeping teams • Collaborate with internal teams on special projects and process initiatives