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Executive Healthcare
Job Opportunities
Send your resume to
info@execuhealth.com or give us a call now.
AVP, Underwriting & Forecasting – Virginia
The AVP of Underwriting & Forecasting is responsible for analytical
support for the premium rate setting process, underwriting of new
business, underwriting of acquisition targets, underwriting of
benefit changes and process changes, forecasting, trend development,
and state/regulatory reporting for rate setting for assigned health
plans and products in geographic region. Participate in the
development and implementation of standard, replicable analytical
tools and methodologies required to fulfill all analysis
requirements. Responsible for all analysis in support of the
monthly/quarterly/annual forecasting activities for premium,
medical, and gross margin for all plans and markets in region,
including medical trend analysis. BS degree in business, finance or
mathematics, 4-5 years supervisory experience in actuarial and/or
financial analysis for managed healthcare, ASA designation or
successful completion of 200 credits of Society of Actuaries exams
and previous HMO/Managed Care industry experience required.
Financial Analyst II – Georgia & Florida
Conducts moderate to complex financial analysis and modeling
projects using a variety of the Decision Support systems. Proficient
at data mining and abstracting information from all Decision Support
tools in order to complete financial projects. Performs such
analyses with limited supervision and assists in the training and
development of Level I Financial Analysts. Must have moderate to
advanced knowledge of many healthcare financial topics, for example
hospital reimbursement, cost accounting, operating budgets, capital
investment analysis, profitability statements, accounting
principles, and revenue cycle management and performance
development, ability to abstract data from a number of the decision
support systems in order to complete financial projects, review data
for accuracy and reasonableness before presenting to management,
summarize the analyses in a professional document and communicate
the findings of the project to decision support management and
maintain one of the decision support core functions including the
cost accounting process, charge master management, operating budget,
month end flexible budget process, capital budget, and general
financial and operational analysis.
VP Network Development – Virginia
The VP of Network Development serves as the company advocate for
Providers, ensuring all aspects necessary to develop, maintain, and
improve provider networks support company goals. This position is
also responsible for the development of managed health care delivery
systems. Also, oversees strategic aspects concerning provider
networks providing advice and guidance to the Health Plans and
responsible for maintaining compliance to company standards for
areas influencing the management of provider networks. BS degree in
business administration, healthcare administration or related field
-Master’s degree preferred, minimum 10 years experience in managed
care, with minimum eight years in managed care administration,
documented success in HMO, PPO or hospital management, formal
management experience in managing healthcare organizations.
Senior Reimbursement Analyst – Ohio
Will prepare, review and file the Medicare and Medicaid cost reports
for all of our client’s entities. Will be responsible for ensuring
the appropriate governmental (Medicare and Medicaid) reimbursement
is received for our client’s $3.7 billion gross patient revenue for
the 8-12 entities. Primarily responsible for the proactive
calculations and modeling of new governmental regulatory changes and
impacts as well as variance analysis of third-party liability
accounts. Additionally this position has supervisory oversight of
the Reimbursement Analyst daily work schedule including flow of
information, teaching of reimbursement fundamentals and principals,
review of work and setting of daily priorities. Also assists in
evaluating the cost/quality and feasibility of new and existing
programs and joint ventures. This position supports the Director and
Manager of Reimbursement with many special projects throughout the
year associated with revenue cycle, charge analysis, regulatory and
financial reporting projects. BS or BA in accounting or finance;
understanding of Prospective Payment Systems, reimbursement
regulations and compliance regulations. Minimum of four years
experience in hospital reimbursement. Reimbursement in a large
teaching facility is preferred. Experience in wage-index, IME/GME,
and DSH required. Must have developed delegation skills and be able
to present oral and written reports to all management levels.
Transplant Analyst – Kentucky
Our client is a regional healthcare consulting firm and is seeking
to fill a FT Transplant position. Candidates must either be a
Registered Nurse with 5 years clinical experience with 2 of those
years in Transplant Case Management in BMT and Solid Organ
Transplant or should have experience in utilization review and
transplant claims administration and be familiar with insurance
company transplant agreements and contracts. Candidate must be
knowledgeable of the pre/post transplant process including the
evaluation, transplant and follow up.
Analyst, Medical Economics– Virginia
The Analyst of Medical Economics develops, coordinates, and provides
financial and technical support for all products, supports customers
(plan and corporate) with statistical analysis, medical management
reporting, and data management. Works with health plans to develop,
maintain, and enhance medical expense budgeting including
identifying utilization targets and corrective action plans
consistent with company goals. Will also develop, maintain, and
enhance mechanisms to track, report, and provide feedback on company
utilization performance, conduct analyses of medical costs versus
expense and is proactive in recommending changes for earning
improvements, provides detailed financial support to all functional
areas relative to key medical cost management and earnings
improvement actions. Works with management and health plan to
identify earning medical improvement opportunities. Provides support
in areas of medical cost management and variance analysis. Conduct
analyses of membership mix and its resulting impact on revenue and
analyses of utilization using statistical principles and tools.
Evaluate and recommend distribution of various risk pools and
quality incentive pools (e.g. PQIP and HARP) consistent with company
established targets and actual results. Provide analyses and support
for financial evaluation of partnership modeling and merger and
acquisition activities as requested. Support the development of
software (such as automated monthly reports and medical budgets)
designed to position the company for continued growth. Evaluate
outcomes of pricing and underwriting procedures Supports and
Performs ongoing analysis and evaluation of fee schedules, benefit
design impact, and contract financial terms for existing, expansion
and new market health plans and providers. Analyze business
opportunity markets and performs preparatory work for ensuring all
cost items are reviewed and comparative data is prepared. Bachelor’s
degree in business, finance, healthcare or related field, minimum of
1-3 years financial and statistical experience in medical expense
analysis and previous HMO/Managed Care Industry experience
preferred.
Chief Financial Officer - Kentucky
- 100 bed behavioral hospital
- Excellent financial planning
- Prior Controller/CFO experience
- $75k-$95k
Reimbursement Consultant – Florida
- Multi hospital corporate position
- 2-5 years reimbursement experience
- Prefer CPA and/or multi hospital background
- $60k-$80k
Finance Professionals – USA
- National Consulting Firm
- 8-12 years experience
- CPA required
- No relocation; 75% travel
- Compensation open; depends on level of candidate
- Experience on provider/payor side
Audit Consultant – Georgia
- Accounting / Consulting firm
- 5-10 years experience
- CPA preferred
- Regional travel – Southeast
- $50k - $90k
AVP, Encounter Management – Virginia
- accountable the overall direction and performance of the encounter
management team and associated processes
- establish policy and develop quality programs that support
maximization of the rate setting process for all state Medicaid
programs
- Monitor and resolve problems involving compliance with state
contracts
- 5-8 years experience in healthcare/managed care industry
- Management experience required
Patient Accounts Supervisor – Georgia
- Medicaid experience required
- 2+ years experience in patient accounts
- Strong demeanor; ability to communicate positively
- Some college courses |
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