Manager, Finance Commercial Operations

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!

Reporting to the Director of Finance Analytics, the Finance Commercial Operations Manager is responsible for the management and oversight of daily Covered California financial operations and reporting, premium billing activities, commission payments, and monitoring of third-party vendors that impact financial activities. This position also reviews monthly revenue reconciliation reports and data, reviews and approves grace period/termination/suspended member notifications, and reviews and recommend updates to financial policies for Covered California

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.
• Telecommute 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. Oversee the daily activities of the premium billing team, ensure timely and accurate Covered California premium invoicing and recording of payments, and issuance of refunds. Review and approve reports related to premium billing and premiums received. 15%
2. Manage Covered California premium data and create reports for management, internal auditors, and external parties, such as regulatory and independent auditors. Maintain accurate and complete financial records and participate in audits or reconciliations, as needed. Communicate department metrics to senior leadership effectively. - 10%
3. Guide Team Members in resolution of errors and issues, assist with research, and analyze data effectively through the understanding of Covered California processes and systems. - 10%
4. Ensure compliance with Covered California, CMS, DMHC, and other applicable regulatory requirements. Understand and interpret policies, procedures, and regulations. -10%
5. Ensure quality control over premium billing operations including, but not limited to grace period notices, suspension notices, and cancellations related to non-payment of premiums. Evaluate, develop, and improve department controls, systems, and procedures that increase accuracy and efficiency and prevent fraud. - 10%
6. Manage reconciliations between multiple revenue streams and enrollment data. -15%
7. Work with various departments and Covered California BPO vendor to resolve issues, expedite requests, provide high-quality customer service, review programming modifications, and/or other business needs. 10%
8. Support financial reporting with revenue accruals related to member premiums, APTC, state subsidies, premium credits, and other relevant accruals. -10%
9. Assist in the formulation of department policies and procedures. - 5%
10. Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each Team Member within IEHP guidelines. -5%
11. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• Minimum of five (5) years of relevant managed care, premium billing, and/or other related experience
• A minimum of two (2) years in a supervisory capacity
  • In lieu of supervisory experience, a Master's degree in a related field from an accredited institution or CPA License is required
• Bachelor's degree in Finance, Business Administration, Economics, Health Care Administration, Accounting, or other related field from an accredited institution required
• Master’s degree from an accredited institution preferred

Key Qualifications

• Strong knowledge and understanding in the following areas:
  • Generally accepted accounting principles (GAAP) and the practical application of general accounting theory
  • Commercial health plan billing practices
• Proficiency in Microsoft Office with advanced Excel skills
• Excellent problem-solving skills and strong analytical skills
• Demonstrated leadership and ability to mentor and train subordinates
• Proficiency in Microsoft Office with advanced Excel skills
• Proven ability to:
  • Lead a high performing team
  • Possess a high attention to detail
  • Communicate effectively at all organizational levels both orally and written
• Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership

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

Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)