Role: Reporting to the Chief Financial Officer (CFO), the Director of Elder Service Plan ("ESP") Finance provides strategic financial support for Harbor's ESP, a Program for the All-Inclusive Care for the Elderly. Managing a team of three staff, you will ensure accurate revenue reimbursements for all enrolled participants, serve as the finance business partner to the Senior Vice President, Elder Service Plan and collaborate with senior leadership to ensure compliance with all federal and state regulatory and financial reporting requirements. You will also drive the annual budgeting for the Elder Service Program and assist in managing vendor relationships and contracts.
Responsibilities include: Financial Oversight
- Leads the annual budget process for the Elder Service Plan.
- Analyzes Monthly Budget to Actual variances and provides financial report to the program Senior Vice President and clinical staff.
- Analyzes utilization and medical expense data and recommends changes for improved efficiency and accuracy.
Medicare and Part D
- Ensures timely and accurate submission of all Risk Adjustment Process System (RAPS) and Prescription Drug Event (PDE) data to Medicare.
- Manages the Medicare Part D bid, reporting and compliance
- Manages relationship with PBM and pharmacy vendor
Strategic Leadership and Analysis
- Acts as subject matter expert on all issues related to finance in a managed care setting.
- Manages Medicaid cost reporting and partners with industry groups on various projects.
- Maintains knowledge of current fiscal regulations for PACE, Medicare and Medicaid
- Leads contract discussions with hospitals and other medical providers to ensure optimal payment structures for Harbor's Elder Service Plan
Requirements: - Bachelor's degree in Finance or related field required
- Five years of work experience in a managed care plan including two years managing staff required
- Intermediate proficiency with Microsoft Excel and Office 365 Including Word, Outlook an Teams
- Demonstrated proficiency in database management, navigation, and utilization
- Knowledge of healthcare reimbursement principles including Medicare and Medicaid
- Experience with Medicare risk adjustment factor coding and/or Medicare Part D bid and reconciliation
- Excellent verbal and written communication skills communicating with a wide audience (e.g. physicians, senior managers, patients, finance staff)
- Excellent problem-solving skills
- Highly organized to handle multiple tasks simultaneously under tight deadlines
- Ability to take initiative; work independently and as a team player
- Experience in hospital or other health care billing
- Knowledge of diagnostic coding
The salary range and/or hourly rate listed is a good faith determination of base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining actual base salary and/or rate, several factors may be considered as applicable (e.g. location, years of relevant experience, education, training, and other factors as permissible by law). As such, most offers will not be at the top of the salary range.Monday - Friday
40 hours weekly
