Senior Director, Financial Operations and Actuarial Strategy - Emory Health Plan
# Senior Director, Financial Operations and Actuarial Strategy - Emory Health Plan **Emory University** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Director` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Director-of-Finance]` `[Actuarial-Director]` `[Financial-Operations-Director]` `[Health-Plan-Director]` `[Healthcare-Finance-Director]` `[Senior-Director-Actuarial]` `[Remote-Senior-Director-Of-Actuarial-Strategy]` `[Senior-Director-Healthcare-Reimbursement-Operations]` `[Senior-Director-Healthcare-Payment-Operations]` --- ### About the Role Discover Your Career at Emory University Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community. Description Senior Director, Financial Operations and Actuarial Strategy owns the financial infrastructure, controls, and operational oversight that enables sound financial management of EHP's medical, pharmacy, and administrative costs. KEY RESPONSIBILITIES: - Responsible for building and sustaining the financial operating systems, reporting cadences, budget processes, vendor financial controls, and regulatory compliance frameworks that support EHP's growth, governance, and fiduciary obligations as a large self-funded health plan. - Owns EHP's vendor financial management function. - Manages and directs the execution of Third Party Administrator (TPA) and Pharmacy Benefits Manager (PBM) invoice reconciliation, payment accuracy controls, and payment integrity oversight. - Oversees financial performance of key vendors with substantial annual administrative spend, tracking contract compliance, unit cost trends, and administrative fee performance against contractual terms. - Leads contract financial review and interpretation across all vendor and provider agreements, flagging financial risk and ensuring alignment with budget assumptions. - Supports the senior leadership in strategic TPA, PBM, and stop-loss carrier contract negotiations with accurate, current financial performance data. - Owns EHP's regulatory compliance function in partnership with third-party compliance advisors and internal legal and compliance leadership. - Maintains EHP's compliance program for applicable self-funded plan regulations, including ERISA, HIPAA, ACA, and the Consolidated Appropriations Act (CAA) transparency and Mental Health Parity requirements. - Oversees preparation and timely submission of all required regulatory filings and any applicable state filings. - Coordinates internal and external audit processes, maintains compliance documentation and internal controls, and builds toward direct regulatory expertise as EHP's compliance function matures. - Serves as an informed financial partner to senior leadership on actuarial and complex financial matters, including incurred but not reported (IBNR) reserve management, claims lag analysis, and pharmacy rebate accounting. - Develops and maintains EHP's IBNR reserve reporting and reconciliation process, validating lag assumptions and reserve estimates against the plan's reserve fund in partnership with external actuaries. - Owns the accounting methodology for pharmacy rebate accruals, claims runout, and other complex reserve items. - Participates in the annual rate-setting and pricing process, providing financial data inputs, grounding actuarial assumptions in operational and claims experience, and contributing informed financial judgment to the pricing analysis led by senior leadership. - Provides financial data inputs for stop-loss program reporting and benefits design financial modeling. - Manages and develops a team, and, as EHP scales, hires and directs additional staff to support reserve, compliance, and senior leadership modeling needs. - Provides clear direction, professional development, and performance management for all direct reports. - Performs related responsibilities as required. MINIMUM QUALIFICATIONS: - Bachelor's degree in accounting, finance, health administration, business administration, or a related field required and 9+ years of progressive experience in health plan finance, managed care finance, or related healthcare financial operations, with demonstrated depth in financial controls, reporting, and accounting. - CPA or equivalent accounting credential strongly preferred. - Master's degree in business administration, health administration, or a related field preferred. NOTE: Tasks related to this position can be performed remotely with only occasional supported visits to an Emory University location. Emory reserves the right to change this status with notice to employee. Additional Details Originally posted on Himalayas
- Director-of-Finance
- Actuarial-Director
- Financial-Operations-Director
- Health-Plan-Director
- Healthcare-Finance-Director
- Senior-Director-Actuarial
- Remote-Senior-Director-Of-Actuarial-Strategy
- Senior-Director-Healthcare-Reimbursement-Operations
- Senior-Director-Healthcare-Payment-Operations
Наблюдалась 2026-10-13, впервые 2026-10-13, источник — Himalayas (JSON API).