Finance Director
Role Summary
This leadership role supports financial performance, affordability initiatives, and operational transformation across health plan products, with a primary focus on Medicare Advantage. The Director collaborates with teams in Actuarial, Medical Economics, and Operations to drive strategic insights, optimize provider relationships, and improve cost and quality outcomes.
Key Responsibilities
Affordability & Managed Care
- Lead financial analysis of cost drivers and savings opportunities
- Develop ROI frameworks for clinical and managed care initiatives
- Translate performance trends into actionable strategies
Provider Contracting & Network Analytics
- Assess financial impact of provider agreements (value-based, risk-sharing, FFS)
- Support contract modeling and performance tracking
- Collaborate with network and clinical teams to improve outcomes
Value-Based Care Performance
- Evaluate financial results of value-based programs
- Support measurement of incentives, shared savings, and risk-adjusted metrics
- Advise on new payment models and improvement strategies
Cross-Functional Leadership
- Represent finance in enterprise-wide transformation projects
- Drive improvements in forecasting, analytics, and reporting
- Promote transparency by linking financials to operational performance
Financial Planning & Forecasting
- Lead budgeting and forecasting for health plans, especially Medicare Advantage
- Deliver insights to senior leadership
- Enhance planning tools and methodologies
Qualifications
- Bachelor's in Finance, Accounting, Economics, or related field (MBA/CPA preferred)
- 8+ years of progressive finance experience, ideally in managed care or risk-bearing entities
- Strong knowledge of healthcare economics and reimbursement models
- Proven success in cross-functional leadership and operational improvement
- Advanced skills in financial modeling and data presentation
- Excellent communication and stakeholder management abilities
Ideal Candidate Profile
A strategic finance leader with deep managed care experience and a collaborative mindset. Skilled in translating complex data into clear insights and driving operational improvements. Motivated by mission and committed to financial sustainability and better outcomes for members.
FAQs
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