Job Description

Job Summary: This position has accountability for the Medi-Cal Rate Development Template (RDT) and all Supplemental Data Requests (SDR). The ideal candidate will have experience populating regulatory reports using medical claims, encounters, and enrollment data, including having experience working with and querying electronic health records in normalized database formats (SQL,SAS, Etc). This position is the main technical point of contact for the California Department of Healthcare Services (DHCS) with respect to RDT and SDRs. Experience with rate development review / audit / desk review in other markets, such as Medicare BPTs, is a plus. The ideal candidate will be comfortable collaborating with regulators and state actuaries in development of rates and financial reporting. This managing level employee is responsible for providing guidance on financial planning and analysis efforts, directing internal audit processes, ensuring proper development of budgets and forecasts, overseeing financial modeling efforts, and leading strategic financial planning efforts. Essential Responsibilities: + Demonstrates continuous learning and maintains a highly skilled and engaged workforce by aligning resource plans with business objectives; overseeing the recruitment, selection, and development of talent; motivating teams; preparing individuals for growth opportunities and advancement; staying current with industry trends, benchmarks, and best practices; providing guidance when difficult decisions need to be made; and ensuring performance management guidelines and expectations drive business needs. + Oversees the operation of multiple units and/or departments by identifying customer and operational needs; analyzing resources, costs, and forecasts and incorporating them into business plans; gaining cross-functional support for business plans and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring progress; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; and ensuring products and/or services meet customer requirements and expectations while aligning with organizational strategies. + Directs internal audit process, reviews audit results, and engages with auditors to resolve complex issues, implement changes to internal controls and proactively assess high risk areas. + Ensures budgets and/or forecasts are developed in accordance with business strategic initiatives by overseeing budgeting trends; directing budget and forecasting; and overseeing development of department/regional budgets. + Advises region/business unit leaders on strategic fiscal matters by overseeing regular and special reports for both financial and statistical matters in order to facilitate financial management throughout the organization; leading regular meetings with leadership to review financial results for their areas; and overseeing advice given to the Kaiser Senior Management team on reading and interpreting financial results, analyzing variances, and improving performance. + Directs financial modeling by overseeing development and application of models; driving the optimization of risk alternatives; and overseeing development of what-if scenarios and forecasts. + Directs the business vision, objectives, and strategic initiatives by reviewing financial impact. + Directs costing activities by overseeing identification of cost avoidance and cost recovery opportunities and application of adequate solutions. + Oversees performance/operations/financial state by directing the use of templates (e.g., cash flow, RFA process, weekly unit case report) and computer applications; making decisions based on financial analyses and results (e.g., operating cash flow analyses, pro forma P&L, line item walk forwards, volume building blocks, NPV, IRR, Discounted Cash Flow, statistical analyses, economic analyses); and monitoring variance analysis and results (e.g., volume, P&L line item, cost of goods, rate). + Oversees reports of region/business unit financial information by directing use of financial trends, data analysis reports, and forecasts of income and expense; providing recommendations; monitoring assets, liabilities, revenues, and expenses; and directing the use of data/inputs from region/business unit systems to support analyses (e.g., membership and utilization reports, volume reporting, day sales inventory, analysis spreadsheets, investment schedules). + Ensures field operations are supported by overseeing their operational/financial performance; identifying areas of improvement and recommending complex solutions. + Directs Financial Statement Analysis of business partners (e.g., suppliers, customers, co-packers, acquisition targets) by overseeing information reported from software systems (Internet, Bloomberg, and D&B), annual reports, and/or interviews; ensuring that the financial status (viability) of business partners is adequate; and monitoring risk implications. + Drives financial performance by reviewing financial trends and results; and advises senior leadership on ways to improve performance. + Leads strategic financial planning by overseeing reporting of financial, utilization, and benchmark data. + Leads strategic financial planning by directing financial plans, acquisition activity, financial requirements, and operating forecasts; and driving development of financial concepts for financial planning and control. Minimum Qualifications: + Minimum four (4) years supervisory experience + Minimum three (3) years experience managing operational or project budgets. + Bachelors degree in finance, business, or related field and Minimum ten (10) years Financial Planning & Analysis experience, or directly related business experience. Additional equivalent work experience in a directly related field may be substituted for the degree requirement. Additional Requirements: COMPANY: KAISER TITLE: Finance Director - Rate Development - Medicaid LOCATION: Oakland, California REQNUMBER: 1351537 External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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