Humana - Sacramento, CA

posted 4 months ago

Full-time - Senior
Remote - Sacramento, CA
Insurance Carriers and Related Activities

About the position

The Director, Market Finance plays a crucial role in our organization by collecting, analyzing, and reporting on various market data to connect financial outcomes with operational effectiveness. This position requires an in-depth understanding of how organizational capabilities interrelate across functions or segments. The Director will be accountable for providing direct leadership to a team of associates focused on value-based provider contracting, provider network analysis and optimization, and identifying local trend bender opportunities. This includes managing the valuation of provider risk deals, recommending impactful changes to provider networks, and collaborating closely with regional leaders to identify and value solutions that help manage cost trends. In this role, the Director will work closely with internal and external associates at various levels, from analysts to VPs, and must be adept at tailoring communications appropriately. The position involves significant interaction with the RVP of Operations, including exposure to Medicare Advantage bid strategy, regional operations staffing, and administrative expense oversight. As the team is established and capable of managing day-to-day tasks, the expectation is that the Director will begin to make direct contributions to these areas. Regular interfacing with regional and divisional leaders, as well as external interactions with VP+ associates at key providers, is a key aspect of this role. The Director will lead a team of 4-5 direct staff, including a Market Finance Lead, and will be responsible for creating a culture of high performance through accountability and engagement. This role includes substantial visibility to the regional senior leadership team and exposure to a broad spectrum of corporate business partners and leaders, as well as significant visibility to external provider partners. The Director will support Humana's Medicare Advantage product strategy, budgets, and administrative staffing and expenses, leveraging data analytics, business insights, and strong communication skills to drive optimization of financial and operational performance for the region. The position requires advising regional leadership on functional strategies while exercising independent judgment and decision-making on complex issues with minimal supervision.

Responsibilities

  • Collect, analyze, and report on various market data to connect financial outcomes with operational effectiveness.
  • Provide direct leadership to a team of associates in value-based provider contracting and provider network analysis.
  • Manage the valuation of provider risk deals and recommend impactful changes to provider networks.
  • Work closely with regional leaders to identify and value solutions to manage cost trends.
  • Interface regularly with regional and divisional leaders, including external interactions with VP+ associates at key providers.
  • Lead a team of 4-5 direct staff, creating a culture of high performance through accountability and engagement.
  • Support Humana's Medicare Advantage product strategy, budgets, and administrative staffing and expenses.
  • Leverage data analytics and business insights to drive optimization of financial and operational performance for the region.
  • Advise regional leadership on functional strategies and exercise independent judgment on complex issues.

Requirements

  • Bachelor's degree in Business, Finance, Accounting or a related field.
  • 7+ years of operations and/or finance experience in the health solutions industry.
  • 3+ years of leadership experience.
  • Experience building a high performing team to support a growth market.
  • Excellent communication and presentation skills.
  • Experience leveraging data analytics to identify improvement opportunities and influence change.
  • Experience developing methods and criteria for measuring and summarizing data for complex analyses.
  • Ability to travel up to 20%.

Nice-to-haves

  • Located in Austin, TX.
  • Certified Public Accountant (CPA).
  • Master's Degree in Business, Finance, Accounting or a related field.
  • Knowledge of the local market dynamics - TX, AR, OK.
  • Knowledge of both group and individual Medicare products.
  • Experience working with physician groups, provider contracting, market operations, and Medicare Risk Adjustment and Stars/Quality functions.

Benefits

  • Medical, dental and vision benefits.
  • 401(k) retirement savings plan.
  • Paid time off, including company and personal holidays, volunteer time off, paid parental and caregiver leave.
  • Short-term and long-term disability.
  • Life insurance and many other opportunities.
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