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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:
  1. Own topline, medical expense, and local/direct SG&A portions of annual budget process & quarterly forecasts a
  2. Conduct/coordinate all analysis required for membership, premium yield, medical expense, and local/direct admin by product
  3. 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.)
  4. On a monthly and quarterly basis, provide necessary information to Actuarial for the medical accruals including:
  5. Full participation in monthly operational meetings, financial statement meetings, and medical accrual meetings.
  6. 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.
  7. 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
  8. 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
  9. 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
  10. 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
  11. Monitor monthly claims production, including investigation and resolution of adverse changes in production statistics and their impact on medical accrual estimates
  12. 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
  13. Monitor, analyze, and report any variances for local and direct administration expenses 13
  14. Identify and drive opportunities for savings with Plan leadership on a monthly basis
  15. Work with Actuarial to understand key drivers of the premium development for each product
  16. 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