Director of Financial Planning & Medical Economics

The Director of Financial Planning & Medical Economics at BMCHP is a key member of the Finance management team whose responsibility is to evaluate, monitor, and report key financial metrics, medical cost forecasts, and state bidding revenue analyses to senior leadership.

Key Functions/Responsibilities:
•Oversees, maintains and enhances crucial medical cost budget forecasting models and profitability reporting for all products. Responsible for delivering detailed monthly forecast reporting packages to the CFO for Executive leadership, the Board of Trustees, and BMC Health System Finance Committee. Must have advanced analytical skills and modeling experience and strong attention to detail.
•Leads the evaluation of actuarial assumptions used in budgeting, forecasting, and pricing.
•Researches and validates assumptions used as input to forecast and budget models.
•Has a strong understanding of financial planning as it relates to health insurance, particularly as it pertains to the value based provider payment models.
•Serve as a liaison between BMCHP and its ACO partners for providing and explaining ACO entity specific inputs, assumptions, supporting information and risk share calculation from BMCHP’s budget forecast model.
•Designs and develops analytics used for Capitation Rate bidding and/or rate acceptance for new programs.
•Oversee regulatory reports development and submissions to state Medicaid programs, including Revenue/Expense, utilization, MLR, and risk mitigation settlement.
•Evaluates and makes recommendations regarding the adequacy of offered state Medicaid program capitation rates.
•Coordinates with various departments and cross-functional teams to capture, value, and scorecard medical cost savings initiatives.
•Makes recommendations to protect the organization’s financial integrity.
•Prepares highly complex financial/actuarial reports and presentations and communicates to executive leadership.
•Works with analysts, actuaries and/or other consultants for supporting corporate initiatives/projects that require analysis of health plan data.
•Uses depth of knowledge and experience to guide and develop colleagues, existing staff and/or actuarial students


•Bachelor’s Degree in Finance, Health Care Administration, or related field required. Master’s Degree strongly preferred.

•Eight or more years’ progressively responsible experience of data management and actuarial analysis with a minimum of four years in a management position within a healthcare insurance environment required.

Competencies, Skills, and Attributes:
•Ability to use well developed interpersonal skills to lead and direct the efforts of others, both internally and externally required.
•Ability to develop, maintain, and strengthen relationships at all levels throughout the organization.
•Proficiency in SAS/SQL and MS Excel.
•Working knowledge of other MS tools, including MS Office products, MS Access, MS Project.
•Must be able to conceptualize and envision the impact of change, and propose new ways to do business. Strong analysis skills are required.
•Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems. Project management skills a plus.
•Strong communications skills, both verbal and written, are required.

*Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

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