Remote Director, Revenue Management (Medicare Advantage)

Summary

Join our team as the Director, Revenue Management (Medicare Advantage) and lead the performance analysis and financial reporting for our Medicare Advantage line of businesses.

Requirements

• Bachelor’s degree in related field or equivalent work experience required
• 9+ years experience in health economics, finance, and/or value-based care revenue forecasting. Minimum of 5+ years specialization with Medicare Advantage
• 3+ years management experience within a health care setting (ACO, payer, practice, etc)
• Deep knowledge of value-based care methodologies
• Deep knowledge of Medicare Advantage methodology and economics (contractings, bidding, P&L management, policy)
• Ability to create and translate complex analysis to executive presentations for senior leadership
• Advanced ability with Excel / Google sheets and data manipulation skills (eg, SQL/SAS/R)
• Advanced knowledge of Medicare Advantage revenue and claims payment/processing
• Familiarity with CMS risk adjustment methodologies and payment

Responsibilities

• Lead team that oversees the financial analysis of Medicare Advantage value-based contracts
• Review payer financial and quality reporting for accuracy and adherence to agreed-upon methodologies
• Develop financial inputs for our revenue recognition and long range plan (LRP)
• Manage the development and maintenance of financial tools (eg, Market Performance Outlook Reports) to report financial performance and revenue projections to internal and external teams
• Provides input to key stakeholders on prioritization of contracts for allocation of resources (eg, field teams, app logic, HQ teams)
• Perform due-diligence on payer reporting and financial reconciliation
• Provide oversight and guidance on ‘service fund audit’ function. Work collaboratively with internal and external stakeholders to adjudicate issues, disputes, and contestations
• Support payer partnership negotiations by modeling performance and creating recommendations for financial terms
• Communication of financial outlook to internal and external stakeholders. Provide actionable recommendations for field teams and HQ leadership
• Oversee network optimization projects for practice portfolio management

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners
• Robust time off plan
• 21 days of PTO in your first year
• 2 Paid Volunteer Days & 11 paid holidays
• 12 weeks paid Parental Leave for all new parents
• 6 weeks paid sabbatical after 6 years of service
• Educational Assistant Program & Clinical Employee Reimbursement Program
• 401(K) with up to 4% match
• Stock options