New Hyde Park, New york
Vice President of Finance Job Opening in New Hyde Park, New york - Integra Managed Care is at the forefront of New York?s MLTC program. We currently serve Manhattan, Queens, the Bronx, Brooklyn, Staten Island, Nassau, Suffolk and Westchester. Named as one of the ?Fastest Growing NY-Based MLTC in 2017?, Integra provides care for adults living with long-term disabilities. Our goal is to help our members live safely and independently in the comfort of their own home.
In this role you will be responsible for the development and implementation of financial policy providing financial analysis as it relates to the delivery of MLTC and Medicare products and services.
Additional duties include:
Develop and implement all Medicare & Medicaid operations of the Finance department and all related activities
Lead the organization?s annual Medicare BID process, including preparation of administrative expense budgets (Parts C& D) and the cross functional team of the organization's leadership, consulting actuaries, PBM and others as appropriate
Support the CFO and other organization leadership financial and operational analytical needs
Ensure CMS Compliance for all Medicaid and Medicare Finance requirements
Manage and reconcile the billing to the State and Feds for all Members
Manage and reconcile the billing of surplus to qualifying members. Bill members monthly for surplus when applicable.
Bill State monthly or as needed for MLTC, and FIDA
Bill Fed monthly for FIDA and MAPD.
Reconcile all billings to cash received. Reconcile billing to eligibility. Process appropriate entries to reflect the billing activity in the general ledger.
Prepare reports to compare claims paid to authorizations given in order to determine IBNR for MLTC and the Long Term portion of FIDA.
Work with actuaries to prepare the IBNR estimate for the Medicare portion of FIDA and MAPD. Liaise with external auditors for audit requests.
Validate claims payments.
Ensure all company insurances are in place and current. Oversee all financial elements of the Plan.
Prepare all reports for regulators.
Preparation of all Medicaid & Medicare Financial Analysis, Reconciliations, and Attestations
Train, supervise and provide guidance to Finance staff on Medicaid (MLTC) and Medicare
Development of Finance Medicare Policies and Procedures
Determine and modify the organization?s general ledger and financial reporting for MLTC and Medicare FIDA
Identifies learning strengths and needs
Utilizes learning resources
Required Skills:
7+ years of Finance/Accounting experience with Medicare/Medicaid health plans; 5+ years of experience in a fiscal leadership role in Medicaid and/or Medicare product
Bachelor?s Degree in Accounting, Finance or other job related field
Background working knowledge of the financial operations and reporting for MLTC and Medicare Advantage plans
Knowledge of CMS regulations regarding financial requirements, including reconciliation of MMR, PPR, PPE, P2P and other files to/from CMS and PBM
Experience with managing the annual Medicare BID process
Working knowledge of all aspects of the bid process including benefits development, administrative expense budget for bid and the related schedules required for the bid submission
Understanding of the annual Medicare BID process review/revisions of bid estimates, including rebates and supplemental benefits
Ability to work across the organization interacting with all levels of leadership
Strong analytical skills including the ability to present data to non-financial associates
Working knowledge of claims data, IBNR estimation and financial budgeting
Ability to develop, implement and update Finance Policies & Procedures for Medicare
Desired Skills:
MBA
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Accounting and Finance: 7 years
fiscal leadership in Medicaid and/or Medicare product: 5 years
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