What are the responsibilities and job description for the Director of Finance - Medicare Advantage position at Physicians of Southwest Washington, LLC?
Summary / Objective:
We are seeking a highly skilled and detail-oriented Director of Finance with specialized expertise in statutory accounting, Medicare Advantage reporting, and Medicaid reporting. This role is responsible for ensuring accurate financial reporting, regulatory compliance, and operational efficiency within the Medicare Advantage line of business. The ideal candidate will have a strong understanding of CMS guidelines, risk adjustment, premium reconciliation, and experience working with the Office of Insurance Commissioner (OIC).
In addition, this position may perform and or supervise the completion of accounting and financial reporting functions such as accounts payable, accounts receivable, regulatory filings and tax preparation. The position reports to the Chief Financial Officer and/or the Executive Director of Finance and prepares a variety of financial reports to support organizational strategies and goals specifically around Medicare Advantage. Ensures the integrity of all accounting information by recording, verifying, consolidating, and entering transactions. The Director of Finance must abide by all Human Resources Principles and objectives including confidentiality, projecting a positive impression of the company and ensuring a respectful atmosphere is always maintained.
Leads general accounting and payroll functions either by processing or supervising the following:
- Lead and manage the overall Medicare Advantage line of business including all financial reporting, reconciliations, audits, and state and federal filings.
- Lead and manage the accounting processes related to Medicare Advantage, including monthly close, premium revenue recognition, and risk adjustment accruals.
- Utilize OIC tools to ensure accurate financial data integration, reporting, and compliance with regulatory standards.
- Prepare and review journal entries, account reconciliations, and variance analysis specific to Medicare Advantage contracts.
- Collaborate with actuarial, finance, and operations teams to support bid development, forecasting, and financial modeling.
- Monitor CMS payment files and ensure timely and accurate reconciliation of premium payments and risk adjustment transfers.
- Maintain documentation and controls to support internal and external audits, including CMS and state regulatory reviews.
- Stay current with changes in Medicare Advantage regulations and accounting standards and assess their impact on financial reporting.
- Formulates and administers approved accounting practices throughout the organization to ensure that financial and operating reports accurately reflect the condition of the business and provide reliable information necessary to control operations.
- Supports the monthly end close process and reconciliation processes as directed by the Executive Director of Finance or the Finance & Accounting Manager.
- Processes accounts receivable, generate invoices, tracks payment, records required journal entries and review and approve A/P entries from other finance staff.
- Processes accounts payable invoices, ensures proper documentation and approvals are obtained, review and approve A/R entries from other finance staff.
- Verifies and/or completes payment of invoices associated with accounts payable and ensures payments are charged to the appropriate accounts.
- Ensure timely and accurate filing of necessary tax forms with federal, state, and local government agencies.
- Maintains knowledge of acceptable accounting practices and procedures.
- Prepare depreciation and other fixed asset-related entry adjustments.
- Assist in preparing audit schedules, gathers necessary account information and documents to perform audits (Financial, Tax and MA Plans) and resolve audit issues identified by external auditors.
- Lead and help develop staff members and direct reports.
- Proactive in the resolution of issues.
- Exceed internal and external customer’s expectations by providing professional and personalized service at all times.
- Continue own education by staying informed of industry trends and actively participating in professional development
- Continuously review assigned areas of responsibility and give suggestions on how to enhance service/products.
- Actively collaborates with other financial team members to assess needs and proactively leverage subject matter expertise improve financial performance and decision making.
- Strong analytical and accounting skills
- Exceptional knowledge of Generally Accepted Accounting Principles (GAAP). Knowledge of statutory accounting principles.
- Strong knowledge of CMS regulations, risk adjustment, and premium reconciliation processes.
- Advanced knowledge of bookkeeping and accounting best practices, laws, standards, and state/national regulations
- Intermediate to advanced knowledge of major accounting software packages for both general ledger and statutory accounting. NetSuite and Workday preferred.
- Proactive team player, strong follow-through, quick decision-making abilities and ability to problem solve.
- Interpersonal skills, with the ability to build strong relationships at all levels.
- Strong communication skills (oral, written, presentation) with both external and internal customers.
- Strong organizational, time management and prioritization skills.
- Self-starter. Ability to prioritize given changing conditions and keep to projected schedules
- Must be able to effectively handle multiple projects simultaneously in a deadline driven environment.
- Set a positive example by displaying a pleasant, approachable demeanor and remaining friendly and courteous at all times.
- Excellent computer proficiency (MS Office – Word, Excel and Outlook) including being able to effectively maintain written and computer records in accordance with regulatory agencies.
- Bachelor’s degree in accounting or equivalent from an accredited university.
- Minimum of five (5) years of accounting or financial experience in a fast-paced, dynamic environment with two (2) years focused on Medicare Advantage.
- Experience in consolidated financials for multiple companies and lines of business.
- Experience in statutory accounting.
- Experience in the healthcare field.
- Master’s degree in Business Administration, Accounting or related field.
- Certified Public Accountant license preferred.
- None required for this position.
PSW does not typically hire new employees near the top of the salary range.
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible Spending Account (FSA)
- Health Savings Account (HSA)
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance