Sr. Director of Finance, Medicare
Requisition #: 173598
Location: Johns Hopkins Health Care, Glen Burnie, MD 21060
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: July 19, 2019
Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
The Senior Director of Finance – Medicare Advantage is responsible for creating and facilitating the development and implementation of JHHC programs and initiatives which are acutely designed to stabilize and increase JHHC Medicare Advantage (Hopkins Health Advantage, or HHA) product that currently generate revenue of over $200M annually and growing rapidly. This position manages a highly specialized group of 3+ financial professionals that will support the organizations goal of providing Johns Hopkins Medicine executive leadership with change-based, project-oriented analyses for the HHA product. Analyses performed will be on an as-needed basis to diagnose the reasons for changes and trends as well as propose and evaluate the impact of alternative approaches to business operations. This position would responsible for developing and implementing the following activities in support of HHA decision-making:
- Management and development of all professional staff that directly or indirectly report up through this position.
- Oversee the creation and manage the programmatic budgets and forecasts and monitor and report on a monthly basis.
- Create the financial models for program and product development and analysis to produce financial feasibility and develop product forecasts.
- Create and vet the financial models for new venture / joint venture development and evaluation.
- Ensure the pricing structure strategies and change assessments are in alignment with the current marketplace.
- Responsible for the development and management of the premium rates and contract rates and revenue.
- Ensuring all required financial reporting including annual Medicare bids and all other CMS requirements are met
- Supports and helps lead the implementation of key revenue enhancement programs for HHA (risk score coding, STARs etc.)
- Responsible for the financial analysis, including IBNR review, projections and monthly financial statements.
- Develops the financial and key indicator reporting, establishment of benchmarks, and sets the strategic plans to ensure current and future financial viability in relation to benchmarks and overall corporate strategy.
- Leads the development of materials and communication of HHA financial items to leadership committees including but not limited to: JHHC executives, JHHC board, HHA board, HHA audit and finance committee, HHA health services committee
- Collaborates with cross functional JHHC business units, JHHC executive leadership, Johns Hopkins Health System leadership, and leaders from HHA equity partners, to provide financial acumen and strategic guidance
- Collaborates closely with Healthcare Economics and Actuarial team to provide focused, actionable insights, initiatives, and measurement, around the key levers of financial performance related to HHA including: Risk score coding, STARs, medical expense management, pharmacy expense management, administrative expense management
- Works collaboratively to develop reporting/analysis to direct strategies to ensure revenue accuracy. This will include member stratification and identification in order to direct resources to focus on greatest areas of value and opportunity
- Leads JHHC finance support of audits and CMS reviews related to the HHA line of business
- Oversee the creation of the HHA market financial reporting, budget and five/ten year plans for review and present to the JHHC President, JHHC CFO, Line of Business VP’s/ Leaders, JHHC Board of Directors.
A. Education: Minimum of a Bachelors Degree in Accounting, Finance, or related field.
B. Knowledge: Extensive knowledge of business and financial planning as it relates to all aspects of the healthcare service industry; healthcare terminology; Requires knowledge of financial analysis with physician and hospital claims and familiarity with professional fee reimbursement as well as CPT, DRG, HCPCS, and ICD code sets; Financial and legal due diligence process; Financial modeling, structure development and feasibilities for: insurance products, joint venture development, and other ventures; Procuring and implementing reinsurance; Budget processes and procedures. Direct experience with Medicare Advantage health plans is preferred
1. Extensive database experience (Access experience required, SQL preferred) with an ability to access and manipulate significant amounts of complex data and produce meaningful and useful reports for senior management.
2. A superior ability to verbally (in particular) and in writing communicate ideas clearly with senior management.
3. Experience and an ability to independently prepare financial analysis and business plans that accurately presents the financial impact of proposals as well as other advantages and disadvantages of the proposal (the group you are working with feels you are a true contributor to the process, not just a collector and supplier of date).
4. Ability to produce complex, assumption-driven financial model to project future results and provide meaningful insights to inform strategic business decisions.
5. Has natural inclination and ability to provide outstanding customer service.
6. Dedicated, hard working employee who achieves maximum efficiency and productivity.
7. An ability to suggest creative ideas that generate additional revenues and/or produce cost savings.
8. A detailed oriented, hands on approach to managing the staff and being involved in projects with senior management. Must possess superior knowledge in all skillset noted above.
9. Superior Management skills that fully engage and motivate the staff.
D. Work Experience: Seven to ten years minimum in Actuarial, Accounting, Business or Finance related fields with at least 2 years’ experience in employee management. Significant subject matter expertise with Medicare Advantage plans is preferred.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.