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Vice President, Finance -and-amp; Analytics FJN Job Listing

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Vice President, Finance -and-amp; Analytics - BOTHELL, WA US
 
FJN® JOB Number 12763

Job Description:
Category: Pres., CEO
Job Title: Vice President, Finance -and-amp; Analytics, FJN 12763
Company Name: Molina Healthcare
Division/Client:  
Company Web Site:
Industry/Product: Other; Not Listed  
Annual Salary: Full-Time  
Description:
Responsibilities: As noted. Vice President, Finance -and-amp; Analytics Organization Molina Healthcare Senior Leadership Job Category Job Location Bothell, WA Date Job Posted December 19, 2012 Share with Others in Share Like 0 Jobs Summary Vice President, Finance -and-amp; Analytics Lead financial analysis of the health plans performance. Lead and support financial and operational analysis for Medical Management and Provider Contracting. Review, evaluate and improve company business logic and data sources. Ensure timely creation of management reports. Ensure data integrity. Assist in developing, implementing and monitoring the health plans strategic plan. Responsible for daily operations of Finance and Medical Data Management functions, including systems. Interact with multiple Molina Departments including UM, QI, Finance, Claims, Member Services and Provider Contracting. ESSENTIAL FUNCTIONS Duties and Responsibilities - Review and analyze premium rates received from the state for appropriateness. Develop analysis and arguments to support rate negotiations with the state. Monitor risk adjustment factors applied to rates (as applicable) and evaluate the financial impact of periodic adjustments. - Review and analyze medical cost performance, including provider contract and medical management efficiency, identifying and implementing opportunities for improved profitability. Monitor and compare across regions, populations, provider panels, and external and internal benchmarks. - Review and analyze monthly claims reserves for accuracy. Assist corporate actuarial department in setting monthly claims reserves. - Review and analyze administrative costs, identifying and implementing opportunities for improved profitability. - Review and interpret health plan financial performance with plan staff and corporate accounting staff. Monitor actual to budget performance. Identify and implement appropriate responses to budget variances. Develop and prepare management reports. - Manage health plan functional departments including Reporting and Analysis, Project Management Office, Facilities Services, and Enrollment - Manage relationship with state department of insurance and other regulators for all financial matters. - Develop annual budget. - Reconcile premium receipts to eligibility in QNXT claims system. - Support health plan strategic analysis and planning. - Review and analyze financial terms of provider contracts and recommend changes. Develop scenario modeling and identify cost savings. - Respond to all UM data needs, facilitating care coordination. - Work with and support MHI Healthcare Data Analysis Department to support reporting, financial performance, common metrics and formatting and increase quality in all healthcare data analytical activities. Coordinate activities with corporate personnel to avoid duplication of work. Assure full data support with regard to data needs for quality improvement activities (HEDIS and CAHPS). Provide local plan support for provider report card/performance monitoring activities with regard to quality, pay for performance (P4P) and medical costs. - Represent the finance function by participating on committees, task forces, work groups, and multidisciplinary teams as necessary. - Acts as a liaison to both internal and external customers on behalf of Molina and data management areas. - Manage the encounter process for the health plan, ensuring that all encounters are successfully submitted and that errors are resolved. Ensure the encounter process fully supports rate setting exercises, collection of case rate payments, and maximization of risk scores while complying with all applicable State guidelines. - Maintain cooperative and effective workplace relationships and adhere to company code of conduct. Knowledge, Skills and Abilities - Computer Literacy (Microsoft Office Products) - Interpersonal communication skills - Excellent verbal and written communication skills - Ability to abide by Molinas policies - Ability to maintain attendance to support required quality and quantity of work - Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) - Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers Required Education: - BA, BS, in Finance, Accounting, or related field; Advanced training or experience in healthcare analytics Preferred Education: - MBA, MS in Finance, Accounting , or post graduate training in finance Required Experience: - 10 years progressive healthcare finance or analytical experience. - 5+ years managed care experience, preferably working with the Medicaid Product. - 3+ years previous supervisory/management experience. - 3+ years SQL, programming skills, relational database and financial analysis skills. Preferred Experience: - 3-plus years of accounting/finance experience or [click on "Apply Online" button] Job Education / Job Experience Requirements See above. Technical / Job Skill Requirements See above. Job Licensure / Job Certification See above.
Requirements: Degree: Undergraduate
Language(s): English
Additional Information: Reference Financial Job Network for immediate consideration.
Apply online:
Job Location:
    City: BOTHELL
    State: WA
    Country: US
Travel Required: No
Relocation Provided: No
Submit Resume/C.V.: Yes  
Submit Salary History: Yes 

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Country: US
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