Manager, Finance Operations - Health Plan

Job Title: Manager, Finance Operations | Health Plan | Sioux Falls

City: Sioux Falls

State: South Dakota

Department *: * Health Plan

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

Manages finance operations for the Health Plan including Premium Billing, Self-Insured/TPA, and Claim Payments. Overseeing and
evaluating the activities of the finance staff, and providing for their professional development.

POSITION RESPONSIBILITIES

Under the general supervision of the Director of Finance, the individual will have responsibility for overseeing Finance-related Operational Departments of the Health Plan. These departments include the Premium Billing Department, Claim Payments, and Self-Insured Business including Stop-Loss and Reinsurance. This position is responsible for managing the company’s revenue cycle in support of planning and decision making activities. Reports to the Director of Finance and supports fiscal activities, such as budgets, forecasts, and financial analysis of revenues inclusive of monthly variance and profitability driver analysis. Manages the operation of the department including human resources, short and long-range planning, legal and regulatory compliance, and providing professional and/or technical expertise. For Premium Billing, this Manager has oversight over all health insurance premium revenue as well as other operating revenues for all health plan companies and lines of business. Oversight includes generation and distribution of accurate and timely invoices, proper revenue recognition, cash receipts internal control, collection procedures, renewal and delinquency communication to clients, and accounts receivable management. Plans timing of billing cycles, supervises premium billing related customer inquiry workflows, manages member correspondence regarding the collection of premiums. Supervises premium billing specialists and other staff supporting the revenue cycle. Regarding the cash collections process, oversees accuracy of ACH transactions, payments via card, cash, or check. Ensures accurate and timely cash deposits and internal controls over cash. Coordinates the transfer of cash between various health plan bank accounts. Develops and ensures compliance with revenue cycle policies and procedures for all health plan companies and lines of business. Assists with development of revenue cycle processes and procedures for Health Plan lines of business for new products as needed. Participates as an active member of Health Plan manager team to ensure revenue cycle integration among related departments such as Enrollment, IT, Underwriting, Finance, Regulation, and Audit. For Self Insured Business and Reinsurance, this Manager will oversee cash accounting for claims, TPA fees, stop loss premium and claims submission, client reporting. Will also be responsible for oversight of Reinsurance premium and claims submission, and other reinsurance reporting. Individual will work with various departments across the health plan to create efficiencies and improve processes. Individual will ensure policies and procedures are in place for all job roles and responsibilities within the department, and followed on a daily basis. Individual must be a high level of accountability and work with minimal supervision. Must have experience in managing people and managing a fast-paced and high volume operational process. Must demonstrate reliability, dependability and attention to detail. Must have excellent time management, organization skills, communication skills, accounting skills and computer competency. Must have strong verbal and written communication skills. Must be able to multi-task with interruptions at a high pace. Must be able to maintain confidentiality. Demonstrates personal commitment to the principles, values and ethics of the organization.

DEPARTMENT DETAILS

Five years of health plan finance operations experience preferred. 2-3 years in revenue cycle knowledge.

QUALIFICATIONS

Certified Public Accountant (CPA), Certified Management Accountant (CMA) or other professional certification is preferred, but not required. Bachelor's degree required in accounting, finance, business, healthcare administration, or related field; master's degree desired, but not required. Minimum of 5 years' experience in financial analysis or related accounting fields. Healthcare experience would be helpful.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community,
across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application,
please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .
In compliance with federal law requiring employers to verify new employees' U.S.
employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .

City: Sioux Falls

State: South Dakota

Job Function: Health Plan

Job Schedule: Full Time

Shift: Days

Req Number: req25835