VP - CFO Health Plan - Remote Eligible

Presbyterian Healthcare Services (PHS) exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

The Vice President - Chief Financial Officer is directly responsible for all Presbyterian Health Plan (PHP) financial operations, including accounting, budgeting, finance, long range and capital planning, GAAP and Statutory reporting, regulatory reporting, premium billing, product development, actuarial services, underwriting and enrollment for PHP. The CFO provides strategic and thought leadership to the strategic planning cycle to promote long-term sustainability initiatives, to include administrative and operational efficiencies through emerging technologies, automation opportunities and optimization of existing technologies.

The position is directly accountable for the development and coordination of financial management systems and processes necessary to achieve PHP's strategic, financial, and operational goals. Also, the position is directly responsible for medical economics and actuarial departments and functions, as well as the successful completion of financial internal and external audit and reporting activities.

Remote: Open to remote applicants in the United States, except for the following: Wyoming, North Dakota, and Ohio.

Qualifications

• Bachelors Degree with CPA Certification OR Masters Degree in Finance required.
• 10 years of Healthcare Leadership Experience.
• CFO experience in a Managed Care Organization preferred.
• Relocation to New Mexico preferred, but will consider remote for the right candidate.
  
  

Responsibilities

• A critical member of the PHS system financial leadership team, instrumental in providing strategic and operational insights for the collective financial sustainability in coordination with the other senior financial leaders. Provides insights as the PHP financial leader to the PHS finance committee as a member of the system financial leadership team.
• Oversees the budgeting, long range and capital planning, financial, and metrics reporting functions of PHP to ensure management has appropriate financial information to make informed decisions and can monitor progress toward PHP goals.
• Identifies opportunities for improvement and communicates these to senior leadership. Accountable for the profitability of PHP in conjunction with the President, CMO, and COO.
• Develops financial reports, metrics, external comparisons and budget tools in collaboration with corporate PHS Finance, including rolling forecast updates quarterly within the PHS framework.
• Develops long range projections for PHP enrollment and coordinates this information into the development of plans by the delivery system and medical group.
• Ensures maintenance of internal controls and compliance with state and federal requirements regarding controls, reporting, risked based capital, etc.
• Oversees and coordinates PHS Internal Audit function and coordinates activities with contracted auditing firm(s). Assists the business units in identifying risk, developing an audit plan and conducting follow-up.
• Partners with other health plan senior leaders to develop and assess the financial performance of value based care and payment programs based on aligned incentives, and to oversee the financial reporting and effectiveness of the programs, including overseeing the proper payments and incentives to providers under value-based care programs.
• Reports operational financial results through internal and external audit processes, including a full array of regulatory financial reporting, exception reporting, account reconciliation and reporting to the PHP Board and the various committees of the PHP Board, including leading strategic, financial, budget and long-range financial plan topics with the PHP Finance Committee.
• Oversees the underwriting, product development and actuarial services functions for PHP.
• Negotiates with external parties and analyzes the potential impact of external contracts related to PHP. Communicates results to senior leadership.
• Oversees the management of the revenue process, including Health Plan premium payments receivables and Enrollment functions.
• Manages the finance function through development of goals, selection, motivation, and development of staff, development and administration of operating budgets, and through the continual monitoring and improving quality outcomes.
• As a member of PHP senior management, utilizes organizational, industry, and competitive knowledge to effect business results and desired outcomes through active, collaborative participation in short and long-term organizational decisions.
• Represents the organization to inside and outside constituents and customers through community service, formal presentations, and marketing efforts.
• Understands, embraces and practices continuous quality improvement principles, leading change through effective change management leadership and communication.
• Plans, coordinates and supervises the operational, personnel and financial activities for all assigned departments.
• Participates in the development of PHS's investment policies and strategies related to PHP assets.
• In coordination with PHS Finance, responsible for leading automation and optimization initiatives across a variety of PHP financial functions, including financial reporting and accounting, medical economics and actuarial services. Coordinates all activities through PHS centralized approach to ensure efficiencies and prioritized resourcing.
  
  

Benefits

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About New Mexico

New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Maximum Offer for this position is up to

USD $180.72/Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.