Chief Financial Officer

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 Chief Financial Officer (CFO) is responsible for the financial management of the organization to include premium rate development, actuarial services, Directed Payments, budget analysis/management, financial modeling and reporting, cost benefit analysis, capitation development, claim operations, forecasting needs, facilities, payroll, accounting/treasury operations, internal auditing, risk insurance management, and purchasing including the procurement process.

In addition to providing financial leadership for IEHP, this position will be responsible for actuarial planning, forecasting, and analysis of financial/organizational risk associated with Medi-Cal, Covered California, and Medicare CCI Dual lines of business. The CFO will offer quality, meaningful analyses, and financial perspectives necessary for organizational decisions and strategic/operational planning.

Additionally, the CFO is responsible for the following non-financial department – Claims, Property Management, Facilities, Business Continuity, Medical Economics, and Risk Score Management for Medi-Cal, Covered California, and DSNP products.

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. Oversees and directs budgeting, financial audits, MCO tax, accounting, capitation, purchasing, premium rate development with the DHCS, Covered California, and CMS, procurement of capital equipment, services and supplies, long-range forecasting, risk insurance management activities, recovery of claim overpayments, financial auditing of IPAs and vendors, internal audit, internal controls, and treasury for IEHP.
2. Manages staff to develop and implement procedures and computer application systems necessary to maintain proper records and to afford adequate accounting controls and services.
3. Ensures staff is engaged, well informed, and aligned with organizational priorities through clear communication, ongoing coaching, and professional development opportunities.
4. Provides strategic leadership and insights into IEHP’s business lines while actively partnering with executive leaders to drive alignment, inform decision making, and ensure financial sustainability across the organization.
5. Oversees production of monthly comprehensive financial and actuarial reports.
6. Coordinates treasury activities such as custodian of funds and IEHP’s assets.
7. Appraises IEHP’s financial position and issues periodic reports on the organization’s financial stability, liquidity, and growth.
8. Develops the annual operating and capital budgets.
9. Analyzes, consolidates, and directs all cost accounting procedures together with other statistical and routine reports.
10. Oversees and directs the preparation and issuance of the annual audit.
11. Directs and analyzes studies of general economic, business, and financial conditions and their impact on the organization’s policies and operations.
12. Analyzes trends in expenses to reveal outliers and assist with analysis of potential causes.
13. Reports on financial status monthly at Governing Board meeting.
14. Analyzes financial issues impacting operational areas and the entire organization and recommends appropriate activities to ensure cost efficiency.
15. Oversees the rate development process with Medi-Cal and CMS; develops and maintains collaborative relationships with DHCS, Covered California, and CMS to ensure credibility and influence with rate-setting leadership.
16. Final Reviewer and Signatory for all provider contracts and administrative contracts.
17. Oversees Large Actuarial Department involved in provider analytics, IBNR, fee schedule analysis, risk score accuracy for Medi-Cal, DSNP, and Covered California.
18. Oversees Claims Production and vendor oversight for all lines of business.
19. Oversees Provider Contracting for the overall development and management of IEHP’s provider network, contracting, compliance and provider oriented projects, initiatives, and data analysis.
20. Builds effective relationships with the provider community to align financial strategies, support value based care, and maintain trust through transparency and partnership.
21. Oversees Property Management & Development including Facilities and Business Continuity of IEHP’s property portfolio including property management; maintain and enhance the value of commercial and real estate assets to optimize IEHP’s financial return.
22. Oversees Provider Data Configuration system configurations and integrations related to provider data design and management and financial technical support related to claims and encounter data.
23. Oversees Product System Configuration activities related to the development and implementation of IEHP benefit and product system configuration and related system integrations; includes the development of enhanced system.
24. Oversees cross-functional benefit implementation and clinical procedure code changes from Medi-Cal, Medicare, and commercial products (Covered CA) and its underlying code sets impacting claims payments.
25. Oversees risk adjustment data validations and enforcing coding standards based on guidelines provided by CMS for risk adjustment.
26. Oversees risk coding workflows for risk adjustment models and risk revenue management for Medi-Cal, ACA products and Covered CA products.
27. CEO delegate for reviewing and signing all provider contracts and administrative contracts throughout the company.
28. Builds strong relationships with key DHCS stakeholders, public hospitals, and Board of Supervisors.
29. Provides oversight of actuarial activities including premium analysis, cost trends, IBNR development, and risk management.
30. Ensures internal audits, proper controls, and procedures exist to protect the financial and operational interests of IEHP.
31. Provides guidance and leadership for the Medical Economics Team.
32. Strongly supports and assists with FWA efforts throughout the plan.

Education & Requirements 

• Ten (10) years of experience in finance/accounting with a minimum of five (5) years of experience in a managed care environment, and a minimum of five (5) years of staff management experience
• Experience with Medi-Cal or Medicaid is required and existing Medi-Cal experience and relationships with DHCS are preferred
• Master's degree in a relevant financial field from an accredited institution is preferred
• CPA is preferred

Key Qualifications

• Must have a valid California Driver’s license
• The financial aspects of a managed care health plan, including finance, accounting, capitation, fee-for-service, procurement process, actuarial support, claim overpayments, internal auditing, risk pools, Rate Development Template (RDT)/Directed Payment Program (DPP), risk corridors, and MLR requirements
• Word processing and data entry involving computer keyboard and screens, automobile travel within California

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.)