Director, Finance Analytics

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

The Director of Finance Analytics provides strategic leadership and guidance for revenue reconciliation activities, premium billing revenue cycle activities, financial regulatory and payment initiatives, and supports IEHP’s financial and regulatory reporting requirements.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Lead the strategic and operational management of the end-to-end Medi-Cal member level revenue reconciliation process.
2. Guide the Finance Analytics team on DHCS regulatory reporting (i.e.: Supplemental Data Requests (SDR), Rate Development Template (RDT) reporting, etc.) and Covered CA regulatory reporting.
3. Oversee the issuance of DHCS directed payments (i.e.: Prop 56, Hospital Directed Payments, WQIP, etc.), including provider disputes related to directed payments.
4. Provide guidance on month-end financial reporting process related to Finance Analytics team deliverables.
5. Oversee the DHCS Hospital Directed Payments encounter data reconciliation process.
6. Oversee Covered California financial operational activities such as the timely and accurate Covered California premium billing and recording of payments, verification of Covered CA financial and operational fees/payments, resolution of premium payment errors and issues etc.
7. Coordinate financial reporting data with other Finance teams as it pertains to monthly/year end close, financial reporting, regulatory reporting, and other required reporting.
8. Partner with Covered California vendors for programming modifications, business requirements, SLAs, and/or other business needs related to financial operations.
9. Review and monitor Covered California premium data to make strategic business decisions.
10. Oversee the development of department policies and procedures; understand and interpret policies, procedures, and regulations.
11. Ensure compliance with Medi-Cal, CMS, and Covered California regulatory requirements, as it pertains to Finance Analytics team’s deliverables.
12. Research, analyze, and provide recommendations for complex financial and claims/encounter issues utilizing financial modeling and/or analysis skills.
13. Keep up to date with the knowledge of the healthcare industry in terms of economic, demographic, and/or political trends and developments.
14. Oversee the hiring, supervising, mentoring, and retaining talented Team Members. Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each Team Member within IEHP guidelines.
15. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• Minimum of seven (7) years leading financial and healthcare data modeling, revenue reconciliation, and managing complex projects
• Minimum of five (5) years of leadership experience required
• Experience working with Medi-Cal, CMS, and/or other state sponsored programs
• Experience working with and extracting healthcare data from SQL and other similar database structures healthcare data
• Master’s degree in Business Administration, Public Health, or related field from an accredited institution required
• A CPA license can be accepted in lieu of a master’s degree
• Possession of an active, unrestricted, and unencumbered Certified Public Accountant (CPA)
  • License issued by the California Board of Accountancy preferred

Key Qualifications

• Advanced understanding and knowledge in the following areas:
  • Generally accepted accounting principles (GAAP) and the practical application of general accounting theory
  • Automated financial and accounting reporting systems
  • Principles and practices of managed care, as they apply to finance, including capitation, fee for service, IBNR, risk sharing, and encounter data
  • State funded programs, including regulations, funding mechanisms, and reporting requirements
  • Technical healthcare data knowledge
  • Principles and practices of revenue reconciliation
• High proficiency in Microsoft Applications (Access, Excel, Word and SQL)
• Excellent problem-solving and analytical skills
• Advanced skills in communicating effectively at all organizational levels and in situations requiring instructing, persuading, negotiating, consulting, and advising
• Strong leadership skills
• Proven ability to:
  • Articulate and embrace organizational values, integrates into management practices, and foster their manifestation among staff
  • Initiate, establish, and maintain effective working relationships with individuals at all levels both inside and outside of IEHP
  • Communicate effectively at all organizational levels both orally and written
  • Embrace the Mission, Vision, and Values of IEHP and encourage others

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)