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MetroPlusHealth · 6 days ago

Deputy Chief Financial Officer

New York, NY

Full-time

Onsite

Director/Executive

$260K/yr - $280K/yr

8+ years exp

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. The Deputy Chief Financial Officer is responsible for all financial reporting, rates, analytics, actuarial services, and new business development operations within the Finance Division, ensuring efficient operations within performance standards and regulatory guidelines.

Financial ServicesHealth CareHealth InsuranceInsuranceLife Insurance

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

Qualification

Financial ReportingActuarial ServicesRegulatory ReportingHealth Insurance AdministrationBudget ManagementData IntegrityTrustFunctional/Technical SkillsIntegrityCustomer FocusWritten/Oral Communication

Required

A Bachelor's Degree with a specialization in Finance, Health Care Administration, or a related field

8 years of high-level responsible experience in a leadership role

An equivalent combination of training, education and experience in health insurance financial operations, managed healthcare or related fields and educational disciplines

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

Experience directing and supervising personnel