PACE Finance Director

Responsibilities

• Leads the annual budget process for the Elder Service Plan PACE program.
• Analyzes Monthly Budget to Actual variances and provides financial report to the program Senior Vice President and clinical staff.
• Analyzes utilization and medical expense data and recommends changes for improved efficiency and accuracy.
• Ensures timely and accurate submission of all Risk Adjustment Process System (RAPS) and Prescription Drug Event (PDE) data to Medicare.
• Manages the Medicare Part D bid, reporting and compliance.
• Manages relationship with PBM and pharmacy vendor.
• Strategic Leadership and Analysis:
• Recruits, hires supervises and retains all Finance Dept. staff.
• Acts as subject matter expert on all issues related to finance in a managed care setting.
• Maintains knowledge of current fiscal regulations for PACE, Medicare and Medicaid.
• Leads contract discussions with hospitals and other medical providers to ensure optimal payment structures for Harbor's Elder Service Plan.

Requirements

• Bachelor's degree in Finance or related field required.
• Five years of work experience in a managed care plan including two years managing staff required.
• Intermediate proficiency with Microsoft Excel and Office 365 Including Word, Outlook an Teams.
• Demonstrated proficiency in database management, navigation, and utilization.
• Knowledge of healthcare reimbursement principles including Medicare and Medicaid.
• Experience with Medicare risk adjustment factor coding and/or Medicare Part D bid and reconciliation.
• Excellent verbal and written communication skills communicating with a wide audience (e.g. physicians, senior managers, patients, finance staff).
• Excellent problem-solving skills.
• Highly organized to handle multiple tasks simultaneously under tight deadlines.
• Ability to take initiative; work independently and as a team player.
• Experience in hospital or other health care billing.
• Knowledge of diagnostic coding.

Benefits

• Generous Paid Time Off plus 11 additional Holidays.
• Health, Dental, Vision, Life, & Disability insurance.
• 403b Savings Plan.