AVP Finance / Data Analyst | AMERIGROUP - New Mexico | Albuquerque, NM
The AVP Fianance/ Data Analyst is responsible for owning, managing, and
driving the budgeting, forecasting, data mining, and financial analysis
functions of the health plan to ensure the achievement of membership,
premium, medical expense, gross margin, and local SG&A goals on a
quarterly and annual basis. Major activities owned by this position
include the annual budget, quarterly forecasts, financial statement
analysis and interpretation, ownership of the cost reduction process to
maximize gross margin, and participation in the premium rate-setting
process. The AVP Finance will work collaboratively with health plan and
corporate management in all areas of responsibility to ensure the
organization is focused on current results vs. budget, current financial
performance trends, and the identification and execution of initiatives
to properly manage revenue, medical, gross margin, and SG&A to plan.
PRIMARY RESPONSIBILITIES:
- Own topline, medical expense, and local/direct SG&A portions of
annual budget process & quarterly forecasts
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- Conduct/coordinate all analysis required for membership, premium
yield, medical expense, and local/direct admin by product
- Provide updated topline and medical projections as needed by the Home
Office due to material changes in the business environment (new
membership, new product, new provider contract, etc.)
- On a monthly and quarterly basis, provide necessary information to
Actuarial for the medical accruals including:
- Full participation in monthly operational meetings, financial
statement meetings, and medical accrual meetings.
- On a quarterly basis, provide all necessary information for the other
known liabilities, including detailed analysis for auditor review,
within required timelines of close process.
- On a monthly basis, analyze, interpret, and communicate financial
statement and medical accrual results to plan leadership for the month,
quarter-to-date, and year-to-date
- Identify, assess, document, and monitor all opportunities to
maximize revenue and manage medical expenses to budget/forecast through
membership, premium rate, unit cost, utilization, and cost containment
initiatives
- Fully engage with other Plans and Home Office departments to
identify, define, and use standard tools and analytical approaches,
including use of common data sets. Interaction with Medical Finance,
Finance, Medical Management, Claims, Cost Containment, Provider Service
Operations, and Premium Reconciliation is expected
- Monitor monthly cost containment activity, including investigation
and resolution of adverse changes in collection activity; Provide
direction to Cost Containment Unit for additional expense savings
opportunities not taken
- Monitor monthly claims production, including investigation and
resolution of adverse changes in production statistics and their impact
on medical accrual estimates
- Monitor monthly supplemental revenue collections such as Maternity
kick payments, Newborn kick payment, and reimbursable drugs, including
investigation and resolution of adverse changes in collection activity
- Monitor, analyze, and report any variances for local and direct
administration expenses
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- Identify and drive opportunities for savings with Plan leadership on
a monthly basis
- Work with Actuarial to understand key drivers of the premium
development for each product
- Identify and monitor the assumptions and issues in the rate
methodology that drive financial success including trend, populations
covered, benefits covered, unit cost assumptions, risk adjustment, birth
rates, newborn enrollment rules, special populations (i.e. AIDS/HIV),
utilization assumptions, and program changes.
EDUATION
Required: BA or BS in Accounting, Finance, or Actuarial Science
Preferred: MBA in Accounting, Finance, or Actuarial Science
Years and Type of EXPERIENCE
Required:
- 3-5 years of Finance, Accounting, or Actuarial experience
including budgeting, financial statement analysis, provider contract
analysis, utilization analysis, and basic underwriting.
- 2 -3 years of data mining and data anlysis experience
- 3 - 5 years experience in a managed care company
Preferred: 5+ years of Managed Care Finance, Accounting, or Actuarial
experience in a leadership role in a health plan, including
responsibility for staff.
Specific Technical Skills
Required: Proficient in Microsoft Windows environment including the
Office suite of products, proficiency with database programs such as
Microsoft Access, advanced skills in Microsoft Excel, advanced
analytical skills, and excellent communication skills.
Preferred: Hyperion Pillar, SPSS or equivalent, SQL
PHYSICAL REQUIREMENTS
- Must be able to operate a computer
- Must be able to operate a telephone
- Travel required and must be able to travel on common carriers and to adhere to AMERIGROUP's travel policies.
- Standing and sitting for long periods of time.
- Data Entry using repetitive motions of fingers and forearms.
In accordance with state and federal laws, employment offers are
tendered solely on the basis of qualifications without regard to race,
religion, color, national origin, age, sex, marital status, sexual
orientation, handicap (including disabled veterans) or Vietnam Era
veteran status.
AMERIGROUP administers pre-employment drug testing as a condition of
employment and a satisfactory criminal history background report.
To apply for this position, please copy and paste the following link
into your browser address bar:
http://amerigroup.contacthr.com/12747657
or submit your resume and salary requirements through our homepage at
https://va-psweb.amerigroupcorp.com/psc/agp/APPLICANT/HRMS/c/HRS_HRAM.HRS_CE.GBL?Page=HRS_CE_JOB_DTL&Action=A&SiteId=1&PostingSeq=1&JobOpeningId=9932
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