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CareSourceCA

Director, Finance - Market

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

Salary: 136k-237k USD

United States only

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Job Summary:

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
  • Decision making/problem solving skills
  • 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
  • May be required to travel occasionally

Compensation Range:

$135,600.00 - $237,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

About the job

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Job type

Full Time

Experience level

Salary

Salary: 136k-237k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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CareSource

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