DATE: August 12, 2025

POSITION: Chief Financial Officer

DEPARTMENT: Finance

POSITION SUMMARY:

The Chief Financial Officer (CFO) serves as an officer of the company and is responsible for planning, implementing, managing, and controlling all financial-related activities of the Upper Peninsula Health Plan (UPHP), Upper Peninsula Managed Care LLC (UPMC,) and Upper Peninsula Health Care Solutions (UPHCS) in accordance with statutory and generally accepted accounting principles; this includes all financial reporting required by the Michigan Department of Health and Human Services (MDHHS), the Department of Financial Services (DIFS), and the National Association of Insurance Commissioners (NAIC).

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.

2. Provides strategic financial leadership by guiding short- and long-term financial planning, assessing financial risks and opportunities, and ensuring systems and controls are in place to support sustainable growth and regulatory compliance.

3. Oversees financial modeling and forecasting related to capitation, risk adjustment, and value-based reimbursement arrangements, while ensuring compliance with Medicaid managed care requirements including MLR, risk corridors, and encounter data accuracy.

4. Establishes and maintains financial policies, procedures, and reporting standards, and leads the development and management of annual budgets and financial performance targets.

5. Establishes and oversees procedures and controls for claims processing, encounter submission, and enrollment processing.

6. Oversees plan’s risk adjustment activities, ensuring strategies, operations, and compliance support accurate risk scoring and optimal financial performance.

7. Oversees the actuarial and underwriting functions associated with the development of rates.

8. Collaborates with the investment advisor to develop and oversee investment strategies, ensuring management and alignment of the organization’s portfolio with financial goals and risk tolerance.

9. Ensures compliance with financial directives and regulatory requirements, and oversees all financial and regulatory audits.

10. Serves as a key liaison by communicating financial and strategic information to the CEO, senior leadership, Management Committee, owners, contractors, members, and relevant committees, as needed.

11. Coordinates and monitors capital planning and inventory control program.

12. Provides supervision, training, career development, and leadership to staff of the finance, risk adjustment, and claims departments.

13. Establishes and maintains appropriate relationships within the financial community; chairs or participates on committees as requested.

14. Maintains confidentiality of client data.

15. Performs other related duties as assigned or requested.

POSITION QUALIFICATIONS:

Education:

Minimum:

Bachelor’s degree in accounting, finance, business administration, or a related field

Preferred:

Master’s degree in business administration, health or public administration, finance, or a related

field; Certified Public Accountant (CPA) or similar professional certification

Experience:

Minimum:

Seven (7) to ten (10) years of progressively responsible financial leadership experience, preferably within healthcare or managed care organizations; demonstrated expertise in managing financial operations, budgeting, forecasting, and regulatory compliance

Preferred:

Ten (10) or more years of senior financial management experience in a health plan, managed care, or insurance environment; proven track record in managing capitation, risk adjustment, actuarial functions, and value-based payment models; experience collaborating with regulatory agencies such as MDHHS, DIFS, and NAIC

Required Skills:

Deep understanding of financial principles, accounting standards (GAAP), budgeting, forecasting, and financial analysis specific to healthcare and insurance sectors

Ability to translate complex financial data into strategic insights that drive organizational growth and sustainability

Proven skills in leading cross-functional teams, fostering professional development

Ability to navigate complex financial challenges and regulatory environments with innovative and compliant solutions

Keyboarding proficiency and working knowledge of MS Word and PowerPoint; advanced knowledge of Excel

Excellent human relation and oral/written communication

Excellent organizational abilities

Strong problem-solving and creative skills with ability to exercise sound judgment and make decisions based on accurate and timely analyses

The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.

Physical Requirements:

[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:

Ability to access departmental files

Ability to enter and access information from a computer

Ability to access all areas of the UPHP offices

Occasionally lifts supplies/equipment

Prolonged periods of sitting

Manual dexterity and mobility

Working Conditions:

Works in office conditions, but occasional travel required

Subject to many interruptions

Exposure to complex information and situations requiring periods of intense concentration or interpersonal skills

Occasionally subjected to irregular hours

Upper Peninsula Health Plan

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