Insurance Accounting Manager-Remote in FL Only, Health First Health Plan, Finance Administratio[...]

Health First; United States; Remote; USD 80,000 - 120,000; Full time

Job summary

Health First seeks an Insurance Accounting Manager to oversee the financial accounting of four health plan entities in Florida. This full-time remote role involves leadership of a skilled team, ensuring compliance with all financial regulations, and managing financial statement presentations across multiple business units.

Qualifications

• Minimum 5 years in accounting leadership and 3 years in a Health Plan environment.
• Proficient in analytical and problem-solving skills.
• Ability to manage multiple priorities in a dynamic environment.

Responsibilities

• Oversee accuracy of accounting for health plans with $1 Billion in assets.
• Lead team recruitment, training, and performance appraisals.
• Ensure financial compliance with GAAP and Florida Statutes.

Skills

GAAP

Financial analysis

Team leadership

Analytical skills

Problem solving

Education

B.S. in Business Administration, Finance or Accounting

MBA or CPA

Tools

Peoplesoft

Microsoft Office

Job description

Insurance Accounting Manager-Remote in FL Only, Health First Health Plan, Finance Administration, Full Time - (Job Number: 066430)

Pay Competitive

Location Remote

Employment type Full-Time

Job Description

Req#: 066430 !*!

*This position is a full time remote, work from home opportunity. You must reside within the state of Florida.

POSITION SUMMARY

To be fully engaged in providing Stewardship, Customer Experience, and Quality/No Harm by leading a team of Health Plans accounting. This position has primary responsibility for overseeing and ensuring the accuracy of the accounting for 4 health plans entities worth $1 Billion in annual assets and liabilities. Manage multiple enterprise projects affecting the financial statements, Joint Venture and financial restructuring across multiple business units. Manage the proper presentation of the Health Plans financial statement and integration into the corporate parent’s statements. Manage subject matter experts in Health Plans accounting and integrate with actuarial and other key resources to ensure proper recording of key estimates.

PRIMARY ACCOUNTABILITIES:

Engagement:

• Actively develop, recruit, and train a highly effective team. Build highly engaged with the knowledge, skills, and experience to achieve results and foster retention.
• Communicate and clarify expectations, timeframes, and deliverables.
• Provide leadership that fosters development and growth of team and promote collaborative efforts between operational, clinical, and corporate departments.
• Complete performance appraisals, providing effective guidance and counseling. Provide timely feedback to help others strengthen specific knowledge and develop skill areas.
• Develops and fosters employee engagement that promotes performance and team.

Quality/No Harm:

• Manage the development, maintenance, and reconciliation of Health Plan financial statements that roll up to the Corporate financial packages.
• Accurately reflect Health Plan financial statements in compliance with GAAP and Florida Statutes.
• Remain current on all financial regulations and standards. Ensure compliance with relevant regulations, standards and directives from regulatory agencies and TPA’s.
• Responsible for the oversight and review of all applicable balance sheet account reconciliations with a combined absolute value of $555 million as of 9/30/17.
• Reconcile key estimates and agreements to the general ledger.
• Health Plans Finance Federal and state responsible party for researching and communicating key Health Plans tax, fee, and reporting related requirements and information between Operations and Corporate Finance.
• This position requires IT system and financial understanding and how to accurately present subledger data from multiple Health First IT systems that feeds (Peoplesoft, AMISYS, & EPSI) cross walking to the general ledger.
• Maintains effective internal controls over Accounting and Financial reporting.

Customer Experience:

• Direct the development, maintenance, and reconciliation of TPA and Florida Hospital customer client information needs, assistance with claims, and unique reporting specification requests for past, present, and future timeframes.
• Lead the Health Plan’s accounting responsibility for TPA’s implementing client needs directly aligned with Health First internal controls, Policy & Procedures (P&P’s), and SOC-1 requirements.
• This position is responsible for the Treasury component required by TPA client contracts equating annually to over $325 Million, 100,000 checks.
• Responsible for HFHP close deadline and milestones.

Stewardship:

• Identify areas for efficiency improvements and provide Leadership with recommendations.
• Leads in the ReInsurance RFP process, including a risk analysis, pricing, contractual negotiations, Aggregate Retention refund ($2.1 Million), and necessary reimbursement filings once under contract. This position also plans and manages the proper application of transplant network contracts ($10 Million).
• Direct the enterprise accounting for ongoing, weekly funding for customer client TPA’s with premium equivalents annually of $550 Million, 275,000 checks ensuring positive cash flow, segregation of escrow balances, balance to the bank reconciliations, aging of accounts receivable, and the 1099’s are accurate. Manage the weekly reconciliation for Electronic Funds Transfers (EFT) and paper checks ensuring providers and member refunds are paid timely, accurately, and support the state of Florida escheat process for unclaimed funds.
• Manage the Health Plans preparation and publishing of timely month end close financial statements that roll up into the Corporate Board package after Senior Leadership review.
• Direct and review financial statement account reconciliations that support audit requirements, internal budgeting needs, fiscal year, calendar year, line of business, and market segmentation.
• Manage quantitative financial data analytics to advise the Health Plans’ Leadership on effective strategies as of 9/30/2017to improve revenue ($500+ Million), lower medical expenses ($475+ Million), and lower SG&A expenses ($100+ Million). Identify areas for efficiency improvements and provide Leadership with recommendations.
• Manage cross functional complex implementation and financial initiatives for the Health Plans.
• Directly responsible for properly accounting and reporting on the not for profit (Medicare) and for profit (Commercial, Individual, and TPA) accounting of 150,000+ Covered Lives member revenue, medical expenses, selling, general, & administrative (SG&A) expenses, and the Medical Loss Ratio (MLR%) by multiple lines of business, business units, and TPA customer clients.
• Directly approve Health Plan’s 1099’s annually sent out to providers and vendors for multiple lines of business and business units.
• Directly approve Health Plan’s 1095B’s annually sent out to members for multiple lines of business and business units.
• Direct the completion of schedules and finance support for the Medicare Bid, Commercial Groups and Individual lines of business rate filings, Re-Insurance coverage reimbursements, Project Management Office (PMO), and medical expenses paid through AMISYS capitation modules
!*!

QUALIFICATIONS REQUIRED:

• B.S. in business administration, finance, accounting, or related field, from an accredited college or university required. MBA or CPA desired.
• Minimum of five years’ direct experience in accounting leadership role.
• Minimum of three years’ experience in a Health Plan required. No exceptions
• Knowledge of Commercial, Individual Marketplace, Medicare and TPA rules and coverage required.
• Possess wide variety of skills and knowledge of GAAP, SOC-1, Florida Statutes/STAT.
• Overall understanding of financial systems used by Health First, including the incoming and outgoing EDI transmissions of data, the posting of financial data between multiple computer systems, and the configuration tables within the computer systems.
• Experience with implementing new strategies and management and training of representatives in a changing, growth oriented environment.
• Prior experience and knowledge in the use of Peoplesoft preferred.
• Proficient in Microsoft Office products (SQL, Excel, PowerPoint, Word, Outlook)
• Time management and priority setting skills
• Possess excellent analytical and problem solving skills.
• Possess strong computer abilities and communication skills.
• Demonstrates the ability to relate well with all customers and peers.
• Ability to prioritize and organize to maximize quality, value, and service.

PHYSICAL DEMANDS:

• Ability to travel to multiple locations, including all off-site locations.
• Able to sit and view computer screen for up to three hours at a time.
• Ability to occasionally stand, walk, use hands to handle or feel, and reach with hands and arms.
• Specific vision abilities include close vision, depth perception, and ability to adjust focus.

MENTAL DEMANDS:

• Ability to handle stressful and dynamic work situations while contributing to a team environment
• Able to prioritize and meet deadlines.
• Ability to handle multiple responsibilities simultaneously.
• Ability to work extended hours to meet deadlines and resolve problems.

About the company

Health First is a fully integrated delivery network (IDN) providing exceptional healthcare on Florida's Space Coast. Health First operates four hospitals in Brevard County, offers outpatient and wellness services, administers numerous healthcare specia...

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