Senior Director, Financial Operations, Actuarial Strategy

Job not on LinkedIn

🔥 12 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

📊 Actuary

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Emory University

WebsiteLinkedInAll Job Openings

10,000+ employees

📚 Education

🏥 Healthcare

🔬 Science

Education • Healthcare • Science

Emory University is a prestigious research university located in Atlanta, Georgia. It offers a wide range of undergraduate and graduate programs across various disciplines including arts, sciences, business, law, and medicine. Emory is known for its commitment to teaching, research, and community service, providing students with a comprehensive educational experience while contributing to advancements in knowledge and societal well-being.

📋 Description

• Own the financial infrastructure, controls, and operational oversight for Emory Health Plan's medical, pharmacy, and administrative costs • Build and sustain financial operating systems, reporting cadences, budget processes, vendor financial controls, and regulatory compliance frameworks • Own vendor financial management • Direct Third Party Administrator and Pharmacy Benefits Manager invoice reconciliation, payment accuracy controls, and payment integrity oversight • Oversee vendor financial performance, contract compliance, unit cost trends, and administrative fee performance • Lead contract financial review and interpretation, flagging financial risk and aligning with budget assumptions • Support senior leadership in TPA, PBM, and stop-loss carrier contract negotiations • Own the regulatory compliance function and maintain compliance programs for applicable self-funded plan regulations • Oversee regulatory filings, state filings, audits, compliance documentation, and internal controls • Advise senior leadership on IBNR reserve management, claims lag analysis, and pharmacy rebate accounting • Develop and maintain IBNR reserve reporting and reconciliation processes with external actuaries • Own accounting methodology for pharmacy rebate accruals, claims runout, and complex reserve items • Participate in annual rate-setting and pricing, providing financial inputs and operational and claims-based analysis • Provide financial inputs for stop-loss reporting and benefits design financial modeling • Manage and develop a team, including hiring and directing additional staff

🎯 Requirements

• Bachelor's degree in accounting, finance, health administration, business administration, or a related field required • 9+ years of progressive experience in health plan finance, managed care finance, or related healthcare financial operations • Demonstrated depth in financial controls, reporting, and accounting • CPA or equivalent accounting credential strongly preferred • Master's degree in business administration, health administration, or a related field preferred • Knowledge of self-funded plan regulations, including ERISA, HIPAA, ACA, Consolidated Appropriations Act transparency, and Mental Health Parity requirements • Experience with IBNR reserve management, claims lag analysis, pharmacy rebate accounting, financial controls, reporting, accounting, regulatory filings, audits, and vendor financial management • Ability to manage and develop a team, hire and direct additional staff, and provide performance management

🏖️ Benefits

• Regular full-time employment • Remote work classification: Full Remote – Monthly • Occasional supported visits to an Emory University location • Equal opportunity employment • Reasonable accommodations for qualified individuals with disabilities