Finance Manager

Key Responsibilities

• Serve as a primary contributor to the annual budgeting and forecasting processes, working closely with the Director of Finance to develop comprehensive financial plans with a strong focus on medical expenses and administrative costs.
• Contribute significantly to the development and maintenance of robust longer-term (e.g., 5-year) company financial models that support strategic initiatives, product development, and pricing decisions.
• Participate in capital adequacy planning, including analysis related to Risk-Based Capital (RBC) and Balance Sheet Adequacy Review (BCAR).
• Analyze the financial impact of Quality Improvement (QI) initiatives and other operational programs on overall profitability and Medical Loss Ratio (MLR).
• Prepare comprehensive financial reports and presentations for senior management, highlighting performance against budget, forecasts, and strategic goals.
• Ensure accurate reporting of key financial metrics, including premiums, claims incurred (including IBNR), and administrative expenses for internal analysis and reporting.
• Oversee the internal calculation and analysis of the MLR, providing insights into performance against ACA requirements and internal targets.
• Support the preparation of data and analyses for regulatory filings as needed.
• Assist with financial audits and regulatory reviews, providing requested data and explanations.
• Maintain up-to-date knowledge of changes in statutory accounting principles and healthcare regulations impacting financial reporting and internal metrics.
• Supervise and mentor junior finance staff, fostering a culture of continuous learning and professional development.
• Identify and implement process improvements to enhance efficiency, accuracy, and timeliness of financial operations and reporting.
• Ensure strong internal controls are in place and adhered to for all financial processes.

Qualifications

• Education: Bachelor's degree in Accounting, Finance, or a related field.
• Experience: 5+ years of progressive experience in finance or accounting, with a proven track record of developing complex financial forecasts and long-term company models.
• Technical Skills: Strong proficiency in US Generally Accepted Accounting Principles (GAAP); expert-level Excel skills for financial modeling and data analysis; experience with financial reporting software and ERP systems (e.g., SAP, Oracle, Workday); familiarity with data visualization tools (e.g., Tableau, Power BI) is a plus.
• Industry Knowledge: While direct health insurance experience is not required, a strong aptitude and willingness to quickly learn the intricacies of health insurance operations, including claims processing, underwriting, product lines, Medical Loss Ratio (MLR) calculations, and claims reserving concepts (e.g., IBNR), are essential.
• Soft Skills: Excellent analytical, problem-solving, and critical thinking abilities; strong communication and interpersonal skills, with the ability to present complex financial information clearly and concisely to non-finance stakeholders; proven ability to work independently and collaboratively in a fast-paced environment; high attention to detail and accuracy.
• Preferred Qualifications: CPA, CFA, or MBA; 2-3 years specifically within the health insurance industry; experience with a publicly traded company; Big 4 public accounting experience; prior experience in a leadership or supervisory role.