Finance Director, PACE Program - Strategic Healthcare Finance

Veterans in Healthcare; Boston (MA); On-site; USD 146,000 - 219,000; Full time

Benefits offered by this job

Health, dental, vision insurance

403b Savings Plan

Generous PTO + 11 holidays

Job summary

Harbor Health Services in Boston, MA is seeking a Finance Director for the Elder Service Plan (ESP) to oversee budgeting, revenue reimbursements, and regulatory reporting. You will lead a small finance team, partner with the Senior VP, and ensure compliance with Medicare/Medicaid requirements.

The role requires 5+ years in managed care finance, strong data analysis, and the ability to drive cost-efficiency.

Qualifications

• 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 and 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

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 RAPS and PDE data to Medicare.
• Manages the Medicare Part D bid, reporting and compliance
• Manages relationship with PBM and pharmacy vendor
• Recruits, hires supervises and retains all Finance Dept. staff.
• Acts as subject matter expert on finance in a managed care setting.
• Manages Medicaid cost reporting and partners with industry groups.
• 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

Skills

Financial analysis

Budgeting

Forecasting

Stakeholder comms

Project management

Healthcare reimbursement

Risk adjustment

Medicare/Medicaid

Team leadership

Billing experience

Education

Bachelor's degree in Finance or related field

Tools

Excel

Office 365

Word

Outlook

Teams

Job description

Harbor Health Services in Boston, MA is seeking a Finance Director for the Elder Service Plan (ESP) to oversee budgeting, revenue reimbursements, and regulatory reporting. You will lead a small finance team, partner with the Senior VP, and ensure compliance with Medicare/Medicaid requirements.

The role requires 5+ years in managed care finance, strong data analysis, and the ability to drive cost-efficiency.