Job Ref: TE0002
Category: Finance
Department: FINANCE
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $260,000.00 - $280,000.00
Position Overview
MetroPlusHealthis committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
The Deputy Chief Financial Officer reports directly to the Chief Financial Officer and is responsible for all the financial reporting, rates, analytics, actuarial services and new business development operations within the Finance Division. This position is responsible for the preparation and management of goals, objectives, budgets and results for the organizational unit. This position manages the team to ensure efficient operations within performance standards, corporate policies, regulatory guidelines and budget parameters.
Scope of Role & Responsibilities
Direct involvement and over site of Finance Operations functions and staff.
Actuarial services: for all activities related to our Commercial Health, Medicare, Medicaid and other Government Products.
Rate setting and valuation for Commercial Exchange products as well as other product development.
Medicare MA/PD Bid submissions, desk reviews and audits, IBNR reserving for all lines of business as well as cost of care trending analysis.
Manages the actuarial contract.
Analysis and Regulatory Reporting; direct involvement in the design and production of analytical reporting of revenue, expense, utilization and acuity for all products.
Regulatory reporting to NYS over site agencies including SDOH Medicaid Managed Care Operation Report (MMCOR), Department of Financial Services (DFS-BLANK), and CMS.
Oversite of departmental and Plan wide data, to maintain data integrity and reporting accuracy. Performs reviews of State and Federal Laws, Regulations and contracts, to ensure compliant operation
Provide governance and oversight of Unpaid Claims Liability (UCL) processes, ensuring appropriate internal controls, policies, and review mechanisms are in place to safeguard accuracy, compliance, and reporting integrity.
Oversee the risk reconciliation function for Value-Based Payment (VBP) arrangements, holding teams accountable for process rigor, transparency, and alignment with contractual and financial obligations.
Direct reimbursement operations oversight, including internal teams and external vendors, to ensure accurate claims validation, payment integrity, and adherence to organizational and regulatory requirements.
Interpret economic and financial trends from the P&L to identify risks and opportunities, and proactively drive actions that support the organization’s strategic and financial goals.
Required Education, Training & Professional Experience
A Bachelor’s Degree with a specialization in Finance, Health Care Administration, or a related field; and
8 years of high-level responsible experience in a leadership role; or
An equivalent combination of training, education and experience in health insurance financial operations, managed healthcare or related fields and educational disciplines; and,
Thorough knowledge of the fundamentals of health insurance administration and standards, regulations and laws applicable to health insurance operations, knowledge of business and human resources administration principles, management functions, management processes and functions of health insurance departments, and experience directing and supervising personnel.
Licensure and/or Certification Required
NONE
Professional Competencies
Integrity and Trust
Customer Focus
Functional/Technical skills
Written/Oral Communication
#LI-Hybrid
#MPH-50
...DESCRIPTION Amazon Ads helps brands create experiences that delight customers and deliver meaningful results... ...the relationship for one of our largest Hardlines/Home advertisers. The Principal Account Executive will work directly with Marketing, Media VPs and their...
20 years ago we set the standard for medical scribes. Today were redefining it. ScribeAmerica is a growing organization with real... ...on the front lines and gain valuable experience as a Clinical Assistant. Were proud to be acknowledged as a Best Places to Work...
...Authorized:National - Family ~ Telework Type:Part-Time Telework ~ Work Location: Knoxville, TN... ...the design, development, and evaluation of mechanical components and processes. You will collaborate and support other engineering disciplines for mechanical matters. Your...
...Sales Engineer Civil Site Industry Overview: Our client, a leading manufacturer of civil construction products, is seeking a Sales Engineer for their New England territory. Position: This is a remote role; the candidate must be willing to travel and reside...
....alterdomus.com Alter Domus is currently seeking a Senior Fund Accountant to join our Private Equity Fund Services Team at our... ...otherwise public accounting firm performing audits on private equity or hedge funds; ~ Strong verbal and written communication skills; ~...