Western Highlands Network is a Local Management Entity (LME), Managed Care Organization, serving eight western counties in NC. They are looking for an experienced Chief Financial Officer with a background in Managed Care to join their team in Asheville, NC. Reporting directly to the CEO, the Chief Financial Officer leads and directs the Business Department staff and directly supervises the Controller, Director of Claims Management and the Encounters Director.
Some of the benefits of this exceptional opportunity are:
- Location - Nestled in the beautiful Blue Ridge and Smokey Mountains of Western North Carolina, Asheville has been named one of the top 10 cities to live in America and has been ranked as one of the country’s “best places for business and careers” by Forbes Magazine.
- Benefits - Western Highlands Network offers an excellent benefits package including membership in the North Carolina Local Government Retirement System, company paid Health and Dental Insurance for employees, and a generous leave package.
- Compensation – Salary is determined by qualifications and experience of the candidate.
The Chief Financial Officer plans, directs and coordinates strategic financial analyses and fiscal management of revenues, claims and other expenses to optimize efficiency and economy of operations. Responsible for the overall management of the Business Department including accounts payables/receivables, management and planning of $175,000,000 budget, claims processing, and claims encounters.
- Responsible for various facets of the organization's finances, which include but are not limited to budgeting, forecasting, IBNR calculation, fiscal reporting and financial data gathering and reporting.
- Develops and recommends financial alternatives that meet the organization's overall financial cost/benefit goals and objectives.
- Prepares financial reports on a monthly, quarterly and annual basis and prepares backup data analysis to support the financial statements and reports; ensures that reporting is accurate and timely. Monitors and explains variances within the financial statements, with timely notification of problematic areas and suggested solutions.
- Monitors the Medical Expense Ratio, overall budget, budget verses actual service expenditures, and the Per Member, Per Month (PMPM) capitation payment versus PMPM service expenditures.
- Responsible for development of subsequent year budgets, maintenance of current fiscal year budget, including monthly budget amendments, monitoring and reporting variances; responsible for preparation and distribution of budget revision reports, Service Utilization vs. Budget report, and various other budget reports as requested.
- Performs project management and directs financial monitoring activities for continuing operations within the organization.
- Works closely with Utilization Management/clinical operations in order to assess and monitor clinical/fiscal objectives.
- Works closely with claims director to ensure accuracy and timeliness of claims payment and claims analysis, including, but not limited to, claims cost triangle analysis, claims lag analysis, analysis of high cost services and high cost providers, and analysis of clinical/fiscal cost savings initiatives.
EDUCATION AND EXPERIENCE
- Must have Managed Care Organization experience,
- Minimum of four-year college degree in business, public, or hospital administration
- 7 years administrative experience involving participation in the financial planning and management of a business or governmental program.
- Current knowledge and ability to apply generally accepted accounting procedures.
- General knowledge of information systems; proficiency in using accounting, data analytics and other software packages.
- Prefer MBA and/or CPA, 5 years of financial responsibility with a managed care company. Experience in data analysis, fiscal management, and actuarial evaluation.
Western Highlands Network is an Equal Opportunity Employer