Finance and Analytics Manager

Education / Licensure / Certification:

EDUCATION:

Required:

Bachelor’s Degree in finance, accounting, economics or other related field or 5 years equivalent work experience

Preferred:

Master’s degree in finance, accounting, economics or business

Licensure/Certification Regulatory:

Valid Driver’s License

Qualifications:

EXPERIENCE:

Required:

• 5+ years’ experience in health care industry

• Strong in Word, Excel, Access and PowerPoint

• Experience creating reports with Crystal, SQL, or Tableau

Preferred:

• Medicare Advantage or Part D reconciliation experience

• Experience working with regulatory agencies

• Experience leading/ coordinating projects

• Payroll experience, including payroll systems/vendors

KNOWLEDGE, SKILLS, AND ABILITIES:

Required:

Knowledge| • Understanding of Medicare Advantage and Part D Programs

• Knowledge of planning and budget processes

Preferred: •Knowledge of Medicare Bid Process

• Knowledge of Medicare reconciliations (CMS plan payments, member payments, Medicare Secondary Payer)

• Knowledge of Incurred But Not Reported (IBNR) methodology

Skills| • Strong in the following competencies:

• Decision Making/Judgment

• Problem Solving/Analysis

• Communication

• Creativity/Innovation

Abilities| • Self-motivated with excellent follow through

• Ability to work independently and with a team

CONDITIONS OF EMPLOYMENT:

* Annual flu shot

* Annual TB test (if applicable to your job location)

* Annual HLCs (Healthstream, formerly CBL)-Safety at Work and Corporate Compliance

* Maintain licensure/certification/registry/listing (if applicable to your job)

Job Description:

JOB SUMMARY:

The finance and analytics manager is responsible for developing financial analyses and projections for the health plan, performs required reconciliations, develops models for business needs forecasting and new or continuing business agreements; develops financial and other reports and presentations for management. This positon also is responsible for some health plan accounting functions and special projects.

MAJOR WORK ACTIVITIES:

1.)

• Prepare financial models, cost analysis, development of pro-forma financial statements

• Prepare, analyze and distribute financial information related to the health plan, including analyses of administrative and medical costs that includes trend analysis on core health plan measures 30%

2.)

• Lead or assist in the development and review of all Medicare reconciliations and processes, including but not limited to, CMS plan payment, member premiums, Medicare Secondary Payer, and the Coverage Gap Discount Program 30 %

3.)

• Lead the annual plan and budget cycle, working across the organization to support business owners

• Manage the payroll vendor and process to ensure all regulatory requirement are met and employees are paid appropriately 15 %

4.)

• Assist with the preparation in the annual Medicare Bid process, gathering financial and other data to help management appropriate develop the bid; including leading the analysis of the data 15 %

5.)

• Manage the relationship with and the requirements of the North Carolina Department of Insurance to ensure positive working relationships and all requirements are timely met

• Work with actuaries and accounting vendors in gathering data and performing analysis 10 %

iCARE – COMMITMENTS TO CARE:

Communication

I will create and engage in conversations of possibility.

o I will be open to innovation and creativity.

o I will listen to understand.

o I will bring ideas for solutions and be open to alternative ideas.

o I will be open to constructive feedback.

o I will not engage or listen to negativity or gossip.

o I will be positive when speaking about Cone Health, my department, and my coworkers.

o I will be approachable.

o I will focus on behaviors, not the person, during conflict.

Accountability

I will honor my word.

o I will do what I say when I say I will. o I will “clean it up” when I can’t keep my word.

o I will honor my work agreement.

o I will be “on the court” instead of “in the stands.”

o I will follow up in a timely manner on commitments and requests.

o I will apologize when someone experiences less than excellent service. o I will take responsibility for my actions, decisions and performance.

o I will protect patient safety (best practices: ex – hand hygiene).

Respect

I will assume the best of intentions and embrace differences.

o I will collaborate and seek other people’s input.

o I will demonstrate courtesy, compassion, and respect with my tone of voice and body language.

o I will speak positively about Cone Health – managing up coworkers, physicians, departments, patients and visitors.

o I will ask the person directly involved when I don’t know.

o I will include diverse skills, abilities, strengths, and backgrounds to create better outcomes.

o I will care for myself while also respecting others.

Empowerment

I will own it, solve it, and celebrate it!

o I will offer solutions when problems are identified.

o I will share my input for decisions by participating in forums such as shared governance, town halls, employee engagement survey, brown bag discussions, employee councils, staff meetings, or directly with my manager.

o I will take charge and do the right thing at the right time.

o I will make decisions keeping a balance of service, quality, and cost in mind.

o I will demonstrate Cone Health values.

o I will seek opportunities to celebrate and have fun.

o I will recognize good work.

I have seen and reviewed the job description in its completed form and understand that I will be required to perform all functions listed if hired for this position. I recognize that, if hired, it is my responsibility to notify my manager as soon as possible if I am unable to perform any of the functions of my position for any reason. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job