Manager, Health Plan Finance Operations

Your Future is our Future

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

Position:

Position Summary:

Job Description:

Primary Responsibilities:

• Leadership and Management:
  • Oversee the day-to-day operations of the AP and AR/Premium Billing functions.
  • Manage and develop a team, providing guidance, training, and performance feedback to ensure departmental goals are met.
• Accounts Payable (AP):
  • Oversee all accounts payable processes, including vendor invoice processing, provider claims payment processing, and commission payments, ensuring accuracy and timeliness.
  • Drive enhancements to the AP/invoicing platform to increase efficiency and improve the customer experience.
• Accounts Receivable (AR) & Premium Billing:
  • Own and manage the entire member/group premium billing cycle, including invoicing, collections, cash posting, and reconciliations.
  • Oversee the application of payments from various sources (lockbox, EFT, member portal), ensuring accuracy and timeliness.
  • Manage the collections process for outstanding receivables, including the relationship with the collection agency.
  • Handle correspondence, premium refunds, and adjustments as necessary.
  • Partner with third-party print/mail and payment portal vendors to enhance the customer experience and resolve issues.
• Process Improvement and Compliance:
  • Identify opportunities for process improvements and workflow automation within the AP and AR cycles.
  • Serve as the business lead for system enhancements, including performing User Acceptance Testing (UAT).
  • Ensure compliance with all relevant regulations, including CMS, State DOI, and HIPAA.
  • Serve as the subject matter expert and business owner for all audits (Financial, SOX, State, Federal) related to AP and AR/Premium Billing, including managing evidence requests.

Qualifications:

• Bachelor’s degree in Finance, Accounting, or a related field.
• 7+ years of progressive experience in finance or accounting, including management experience.
• Strong leadership skills and demonstrated success in leading, developing, and managing a team.
• Excellent database skills and financial modeling experience.
• Strong analytical, quantitative, and problem-solving skills.
• Advanced proficiency in Microsoft Office Suite, particularly Excel, PowerPoint, and Access.
• Ability to work in a fast-paced, high-pressure environment.
• Exceptional ability to communicate effectively, both verbally and in writing, with all levels of the organization.
• Self-starter with the ability to work independently and as part of a team.
• MBA
• Previous experience with financial analysis in the technology industry
• Previous experience in a high-visibility role

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Pay Transparency:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

Benefits of working at Lumeris

• Medical, Vision and Dental Plans

• Tax-Advantage Savings Accounts (FSA & HSA)

• Life Insurance and Disability Insurance

• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)

• Employee Assistance Program

• 401k with company match

• Employee Resource Groups

• Employee Discount Program

• Learning and Development Opportunities

• And much more...

Be part of a team that is changing healthcare!

Member Facing Position:

Location:

Time Type:

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.

Disclaimer:

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.