Senior Director, Financial Operations and Actuarial Strategy owns the financial infrastructure, controls, and operational oversight that enables sound financial management of EHP's medical, pharmacy, and administrative costs. KEY RESPONSIBILITIES: - Responsible for building and sustaining the financial operating systems, reporting cadences, budget processes, vendor financial controls, and regulatory compliance frameworks that support EHP's growth, governance, and fiduciary obligations as a large self-funded health plan. - Owns EHP's vendor financial management function. - Manages and directs the execution of Third Party Administrator (TPA) and Pharmacy Benefits Manager (PBM) invoice reconciliation, payment accuracy controls, and payment integrity oversight. - Oversees financial performance of key vendors with substantial annual administrative spend, tracking contract compliance, unit cost trends, and administrative fee performance against contractual terms. - Leads contract financial review and interpretation across all vendor and provider agreements, flagging financial risk and ensuring alignment with budget assumptions. - Supports the senior leadership in strategic TPA, PBM, and stop-loss carrier contract negotiations with accurate, current financial performance data. - Owns EHP's regulatory compliance function in partnership with third-party compliance advisors and internal legal and compliance leadership. - Maintains EHP's compliance program for applicable self-funded plan regulations, including ERISA, HIPAA, ACA, and the Consolidated Appropriations Act (CAA) transparency and Mental Health Parity requirements. - Oversees preparation and timely submission of all required regulatory filings and any applicable state filings. - Coordinates internal and external audit processes, maintains compliance documentation and internal controls, and builds toward direct regulatory expertise as EHP's compliance function matures. - Serves as an informed financial partner to senior leadership on actuarial and complex financial matters, including incurred but not reported (IBNR) reserve management, claims lag analysis, and pharmacy rebate accounting. - Develops and maintains EHP's IBNR reserve reporting and reconciliation process, validating lag assumptions and reserve estimates against the plan's reserve fund in partnership with external actuaries. - Owns the accounting methodology for pharmacy rebate accruals, claims runout, and other complex reserve items. - Participates in the annual rate-setting and pricing process, providing financial data inputs, grounding actuarial assumptions in operational and claims experience, and contributing informed financial judgment to the pricing analysis led by senior leadership. - Provides financial data inputs for stop-loss program reporting and benefits design financial modeling. - Manages and develops a team, and, as EHP scales, hires and directs additional staff to support reserve, compliance, and senior leadership modeling needs. - Provides clear direction, professional development, and performance management for all direct reports. - Performs related responsibilities as required. MINIMUM QUALIFICATIONS: - Bachelor's degree in accounting, finance, health administration, business administration, or a related field required and 9+ years of progressive experience in health plan finance, managed care finance, or related healthcare financial operations, with demonstrated depth in financial controls, reporting, and accounting. - CPA or equivalent accounting credential strongly preferred. - Master's degree in business administration, health administration, or a related field preferred. NOTE: This role will be granted the opportunity to work from home regularly but must be able to commute to Emory University on a flexible weekly schedule based upon business needs. Schedule is based on agreed upon guidelines of department. This role requires residency in the state of GA. Emory reserves the right to change remote work status with notice to employee. #LI-MR1