Description: Position may sit in Hartford, CT or Harrisburg, PA
The Financial Director will be responsible for compliance, reporting and analysis related to Medicare ACA regulations, specifically the minimum loss ratio (MLR) regulations. This position will also lead efforts to drive best practices within the organization and maintain appropriate and effective strategic and financial decision-making processes. This position manages two finance direct reports. The Director is accountable for the effective implementation and execution of all functions that support compliance, financial and strategic implications of the regulations.
This is an advanced finance position responsible for complex functions/assignments requiring advanced analytical and technical skills. This position is a Subject Matter Expert on Medicare Minimum Loss Ratio reporting and the Medicare business. Solid technical skills and a strong focus on customer relations (both internal and external) is critical to the role.
Direct the analysis, quantification and reporting of minimum loss ratio impacts and activities
Accountable for the effective implementation, execution and monitoring of financial functions that support the regulations and associated company strategies and actions
Participates in or leads projects that impact many financial and functional (non-financial) disciplines of the company
Implements a solid management process for communicating and executing related strategies
Partners with business unit leaders to execute short and long-range actions and initiatives and leads execution across various departments
Serves as Subject Matter Expert on the Medicare MLR Annual Filing, Monthly Reserve Calculation, and related business implications
Reviews related Aetna Annual Statements, Supplemental Healthcare Exhibit and Commercial MLR filings to understand and influence impact to Medicare business
Performs analysis of key components of financial results and addresses issues as needed
Provides ongoing insight and review of key MLR components to Senior Management
5-10 years financial management experience including strategic and business planning, accounting and financial analysis.
5+ years Medicare knowledge and related experience generally required, healthcare finance a plus.
Project management experience a plus, including leading project teams.
Experience in healthcare, managed care insurance or financial services preferred.
Bachelor's Degree; Finance or Accounting degree required.
Advanced degree in Business and/or FSA/CPA preferred.
Finance - Financial analysis
Finance - Financial reporting and analysis
Aetna Application - Enterprise Contact Repository
Database - SQL Server
Desktop Tool - TE Microsoft Excel
General Business - Communicating for Impact
General Business - Consulting for Solutions
General Business - Demonstrating Business and Industry Acumen
Finance - Delivering Profit and Performance
Finance - Profit and Quality Vigilance
Additional Job Information:
Influence areas outside of direct control.
Comprehensive business knowledge
Aetna business knowledge (outside department business).
PC skills in Excel, Access.
This Medicare finance position will be challenging at times, but will provide you with a deep understanding of Medicare financials.
The position will provide the candidate:
* A detailed view of the MLR provision written into the Affordable Care Act of 2010 * An understanding of how the Medicare Bid process works * The different Revenue Sources of the Medicare Business * An understanding of the benefits Medicare beneficiaries receive and how those benefits impact MLR reporting * A high level understanding of the Medicare MLR impacts to GAAP and STAT and differences between the Medicare MLR filing compared to the GAAP/STAT reports
If you have an interest in Government Programs and how Medicare impacts the organization, this may be the position for you Required Skills: General Business - Communicating for Impact, General Business - Consulting for Solutions, General Business - Demonstrating Business and Industry Acumen Desired Skills: Finance - Delivering Profit and Performance, Finance - Profit and Quality Vigilance Functional Skills: Finance - Financial analysis, Finance - Financial reporting and analysis Technology Experience: Aetna Application - Enterprise Contact Repository, Database - SQL Server, Desktop Tool - TE Microsoft Excel Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.