Manager, Health Plan Finance Operations

🕒 Maio 20

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Lumeris

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

⚕️ Seguro de Saúde

☁️ SaaS

Healthcare Insurance • SaaS

Lumeris é uma empresa focada em fornecer soluções de cuidados baseados em valor na indústria de saúde. Com mais de uma década de liderança neste campo, a Lumeris faz parcerias com sistemas de saúde para melhorar os resultados dos pacientes e impulsionar o sucesso financeiro por meio de soluções habilitadas por tecnologia. Sua plataforma apoia a gestão da saúde populacional, a transformação da prestação clínica e a contratação de pagadores, oferecendo soluções abrangentes para gestão de pacientes agudos, pós-agudos e de alto risco. A Lumeris é reconhecida por criar economias de custo significativas e alcançar excelentes resultados para os pacientes, incluindo uma classificação de 5 estrelas do CMS para seu Plano de Medicamentos sob Prescrição do Medicare Advantage.

Descrição

• Oversee the day-to-day operations of the AP and AR/Premium Billing functions. • Manage and develop a team, providing guidance, training, and performance feedback to ensure departmental goals are met. • Oversee all accounts payable processes, including vendor invoice processing, provider claims payment processing, and commission payments, ensuring accuracy and timeliness. • Drive enhancements to the AP/invoicing platform to increase efficiency and improve the customer experience. • Own and manage the entire member/group premium billing cycle, including invoicing, collections, cash posting, and reconciliations. • Oversee the application of payments from various sources (lockbox, EFT, member portal), ensuring accuracy and timeliness. • Manage the collections process for outstanding receivables, including the relationship with the collection agency. • Identify opportunities for process improvements and workflow automation within the AP and AR cycles. • Serve as the business lead for system enhancements, including performing User Acceptance Testing (UAT). • Ensure compliance with all relevant regulations, including CMS, State DOI, and HIPAA. • Serve as the subject matter expert and business owner for all audits (Financial, SOX, State, Federal) related to AP and AR/Premium Billing, including managing evidence requests.

🎯 Requisitos

• Bachelor’s degree in Finance, Accounting, or a related field. • 7+ years of progressive experience in finance or accounting, including management experience. • Strong leadership skills and demonstrated success in leading, developing, and managing a team. • Excellent database skills and financial modeling experience. • Strong analytical, quantitative, and problem-solving skills. • Advanced proficiency in Microsoft Office Suite, particularly Excel, PowerPoint, and Access. • Ability to work in a fast-paced, high-pressure environment. • Exceptional ability to communicate effectively, both verbally and in writing, with all levels of the organization. • Self-starter with the ability to work independently and as part of a team. • MBA. • Previous experience with financial analysis in the technology industry. • Previous experience in a high-visibility role.

🏖️ Benefícios

• Medical, Vision and Dental Plans • Tax-Advantage Savings Accounts (FSA & HSA) • Life Insurance and Disability Insurance • Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days) • Employee Assistance Program • 401k with company match • Employee Resource Groups • Employee Discount Program • Learning and Development Opportunities