Vice President, Government Programs Finance (Hybrid)

Resp & Qualifications

The Vice President, Government Programs Finance is responsible for the Financial Management for the Government Programs businesses Medicare, Medicaid, including oversight of the underlying functions of Controller, FP&A, Actuarial, and Treasury / Investments.

May serve as Treasurer on the Boards of the Government Programs legal entities. Serves as the attesting Financial Officer for CMS and for regulatory purposes for related Medicare, Medicaid and other contracts.

ESSENTIAL FUCTIONS :

Directs / Manages Controller functions for Government Programs businesses including but not limited to :

• Financial Reporting, accounting methodology, and controls (SOx and MAR) activities for GAAP and Statutory accounting including monthly, quarterly, and annual financial statements with respect to Insurance Administration reports, BCBSA financial information, Board of Directors and related committee reports.
• Utilizing financial systems to generate detailed reporting to the Medicare, Medicaid and Federal Employee Programs, maximizing the financial advantage to the corporation, through maintenance of accurate databases for the allocation of expenses.

Directs / Manages Financial Planning & Analysis functions for Government Programs businesses including but not limited to :

• Developing single-year and multi-year financial plans consistent with strategic direction and economic conditions.
• Analyzing results and identifying and implementing actions to influence those results, e.g. provider contracting, case and utilization management, benefits design, pricing, etc.
• Developing and monitoring capital plan, including RBC projections and required contributions to Medicare and Medicaid entities.

Directs / Manages, for Government Programs, Actuarial Rate Analysis, Medicare Bid preparation, and IBNR reserve setting, as necessary, including but not limited to :

• Rate analysis and finalization with Medicaid Departments of Health and CMS.
• Benefit design and pricing for Medicare Advantage both Individual and Group.

Perform other Financial Executive duties as assigned related to new corporate ventures, initiatives, and partnerships with other Blues plans related to Medicare Advantage product offerings, etc.

Oversees the strategic and the day-to-day activities of the Department, including directing, coaching, and guiding associates to implement departmental, divisional, and organizational mission / goals.

Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policies and procedures.

Develops annual goals, and prepares, monitors, and analyzes variances of departmental budgets to control and appropriately allocate resources.

Education Level : Bachelor's Degree in Finance, Accounting or similar busienss college of business major OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience : 12 years of experience in health care industry with significant experience in Health Insurance payor experience and 5+ years of Medicaid and Medicare payor experience.

Preferred Qualifications :

MBA or CPA

Knowledge, Skills and Abilities (KSAs)

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.

Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.

Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Department

Department :

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.