Director of Finance

POSITION SUMMARY

The Director of Finance provides financial leadership and operational oversight for CHG’s Medi-Cal and Medicare Special Needs Plans. The Director leads financial analytics, budgeting, forecasting, rate development, and reporting, including supplemental data submissions to state actuaries. The role oversees capitation and revenue, data and claims, and program performance analyses; prepares selected reports and routine supporting journal entries for Accounting; and turns complex results into actionable recommendations. Ensures responsible stewardship of resources and long-term financial sustainability.

COMPLIANCE WITH REGULATIONS

Works closely with all departments necessary to ensure that the processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations including DHCS, DMHC, and CMS and/or Medicare Part D and Special Needs Plans (SNP).

RESPONSIBILITIES

• Lead annual operating budgets, multi-year financial plans, forecasts, and scenario analyses for all lines of business. Analyze premium revenue, capitation and other program payments, medical and pharmacy costs, administrative expense, investment income, and operating results; explain variances and recommend corrective actions.
• Assess financial implications of membership trends, acuity and risk adjustment, utilization, provider contract terms, benefit changes, new programs, and operational initiatives. Develop timely financial reports, dashboards, and decision materials for executive management, the board, committees, and other business owners.
• Lead rate development activities and prepare supplemental data reporting, assumptions, and supporting analyses for management, regulatory bodies, and actuaries.
• Oversee financial analysis of enrollment, capitation, supplemental payments, quality incentives, risk corridors, settlements, recoupments, and other contract-specific revenue or liabilities. Analyze capitation and revenue by line of business, reconcile and explain variances, and prepare recurring revenue analyses and reports for management.
• Partner with claims, EDI, UM, Rx, provider network, and data teams to assess the completeness, accuracy, timeliness, and financial impact of operational data. Conduct or oversee claims and data analyses to identify cost trends, financial impacts, data quality issues, and opportunities for further review; report program performance by connecting financial results with membership, utilization, claims, and operational indicators.
• Prepare or oversee financial reports, analyses, and supporting schedules; provide complete, timely materials to the Accounting team for period close and financial statement preparation and resolve questions or variances with Accounting. Provide training, guidance, and interpretation of financial reports and analyses to staff and management as needed and perform other related duties consistent with the role and organizational needs.

• Promote employee development through ongoing training, coaching, and professional growth opportunities to strengthen staff skills, knowledge, and performance

EDUCATION

• Bachelor’s degree in business or a related field.
• Master’s degree in business administration or a related field.
• CPA active preferred.

EXPERIENCE/ SKILLS

• Minimum of seven (7) years financial or accounting analytics experience.
• Five (5) years with a managed care plan; Medi-Cal/Medicaid, Medicare Special Needs Plan, or health insurer preferred.  Related experience considered.
• Minimum of three (3) years previous supervisory or management experience.
• High proficiency with Microsoft applications including Word, Excel, PowerPoint.
• Proficiency in SQL for data extraction, manipulation, and financial modeling (highly preferred); primary use by staff.

PHYSICAL REQUIREMENTS

• Prolonged periods of sitting.
• May be required to work evenings and/or weekends.
• Occasional traveling, including driving within County of San Diego.

The above statements describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

All qualified applicants will receive consideration for employment based on merit, without regard to race, color, religion, sex, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.