- Directs market leadership for P&L and SG&A budget in a high revenue and highly complex market; operates as a financial liaison to state partners;
- Leads rates management and negotiation including reserve development and analytics; and leads the Medical Cost Trend identification and mitigation process.
- Maintains trends that are appropriate given premium reimbursement; achieves Medical Cost and MLR targets set in plans and forecasts; ensures that provider network contracting efforts obtain the best possible financial arrangements; owns the setting and achievement of Cost of Care targets; and achieves operating gain targets set in budgets and forecasts.
- Provides analytics and reporting for state programs
- Provides multiple standard and ad hoc reporting required by the State
- Provides support for multiple regulatory reports
- Directs Health Plan preparation of annual/bi-annual operating/capital budget and quarterly forecasts to provide senior leadership with tools necessary to maximize investment of resources.
- Directs interface with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
- Requires a BA/BS in Finance, Business Administration, Accounting, or Economics, or related field; 8 – 10 years’ experience in accounting, financial reporting, business analysis, budgeting, forecasting, and strategic and/or tactical planning within a health insurance/managed care environment.
- 5+ years of leadership experience; or any combination of education and experience, which would provide an equivalent background.
- Views self as part of the local Executive Leadership Team.
- Experienced in Iowa ideal, but needs experience in a managed care setting, preferably as finance lead.
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