The Director of Finance, Medical Cost Management is a critical part of the Bright HealthCare Finance team and is responsible for working with leadership to support Bright HealthCare’s product and field finance capabilities of the Commercial lines of business (Individual and Family Plans and Employer Plans). Working under the direction of the Vice President of Finance, Medical Cost Management, this position will directly or indirectly lead a team of finance professionals focused on overseeing centralized medical cost management to identify, size, prioritize and ensure successful execution of medical cost management initiatives. This role will also have responsibilities of executing from a field finance, analytical viewpoint as well as working closely with functional, regional, and market leaders to optimize medical costs.

The successful candidate will be a self-starter and will have a proven track record of succeeding in fast-paced and complex health plan settings. You have a demonstrated ability to connect data analysis across multiple functional areas to actionable and measurable initiatives. You excel at seeing both the “big picture” and the detail necessary to ensure initiatives are being managed with high quality. You will have accountability; are an excellent verbal and written communicator; operate with strong attention to detail. Your colleagues and clients will recognize you for being a positive influence, having empathy towards others, being highly collaborative and strongly exhibit the ability to drive towards measurable outcomes.

ROLE RESPONSIBILITIES

1. Oversee centralized medical cost management team to identify, size, prioritize and ensure successful execution of medical cost management initiatives across the commercial lines of business.
2. Work collaboratively to proactively identify trends, outliers, and opportunities in medical cost.
3. Collaborate with analytical, functional, regional and market teams to strategize on solutions to medical cost opportunities, including identification of trend drivers.
4. Plan, assess and monitor medical costs working with finance, actuarial and others.
5. Strategize to improve the effectiveness and speed of medical cost analytics and related work product.
6. Leverage historical knowledge and experience in medical cost work, including network, clinical and financial baseline knowledge, to inform work plans and mitigate medical cost trend.
7. Provide leadership and guidance to a small team of medical cost analysts and consultants.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
• Bachelor’s degree required
• MBA or similar secondary degree preferred
• Fifteen (15) or more years of health plan finance or medical economics experience
• Advanced proficiency with tools such as Microsoft Excel, PowerPoint, Word, TEAMS, and other tools

PROFESSIONAL COMPETENCIES
• Previous health plan experience, preferably in one of the following areas: financial planning and analysis, market development, market-level finance or operational experience, health care economics.
• Strong collaboration skills to work with internal teams to effectively understand issues and mitigate risks accordingly.
• Experience and strong influential skills to manage cross-functional, virtual teams
• Excellent written and verbal communication skills
• Ability to perform critical analysis to complex business problems and propose solutions
• High attention to detail
• Operates with a sense of urgency
• Strong analytical skills, work ethic, problem solving ability, and overall positive attitude
• Demonstrated flexibility, organization, and self-motivation
• Adaptable to change and ability to deal with rapid, unpredictable change

LICENSURES AND CERTIFICATIONS
• CPA preferred, but not required

WORK ENVIRONMENT
Most work responsibilities are performed remotely or in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.