Position Overview
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
The Deputy Chief Financial Officer reports directly to the Chief Financial Officer and is responsible for all the financial reporting, rates, analytics, actuarial services and new business development operations within the Finance Division. This position is responsible for the preparation and management of goals, objectives, budgets and results for the organizational unit. This position manages the team to ensure efficient operations within performance standards, corporate policies, regulatory guidelines and budget parameters.
Scope of Role & Responsibilities
- Direct involvement and over site of Finance Operations functions and staff.
- Actuarial services: for all activities related to our Commercial Health, Medicare, Medicaid and other Government Products.
- Rate setting and valuation for Commercial Exchange products as well as other product development.
- Medicare MA/PD Bid submissions, desk reviews and audits, IBNR reserving for all lines of business as well as cost of care trending analysis.
- Manages the actuarial contract.
- Analysis and Regulatory Reporting; direct involvement in the design and production of analytical reporting of revenue, expense, utilization and acuity for all products.
- Regulatory reporting to NYS over site agencies including SDOH Medicaid Managed Care Operation Report (MMCOR), Department of Financial Services (DFS-BLANK), and CMS.
- Oversite of departmental and Plan wide data, to maintain data integrity and reporting accuracy. Performs reviews of State and Federal Laws, Regulations and contracts, to ensure compliant operation
- Provide governance and oversight of Unpaid Claims Liability (UCL) processes, ensuring appropriate internal controls, policies, and review mechanisms are in place to safeguard accuracy, compliance, and reporting integrity.
- Oversee the risk reconciliation function for Value-Based Payment (VBP) arrangements, holding teams accountable for process rigor, transparency, and alignment with contractual and financial obligations.
- Direct reimbursement operations oversight, including internal teams and external vendors, to ensure accurate claims validation, payment integrity, and adherence to organizational and regulatory requirements.
- Interpret economic and financial trends from the P&L to identify risks and opportunities, and proactively drive actions that support the organization’s strategic and financial goals.
Required Education, Training & Professional Experience
- A Bachelor’s Degree with a specialization in Finance, Health Care Administration, or a related field; and
- 8 years of high-level responsible experience in a leadership role; or
- An equivalent combination of training, education and experience in health insurance financial operations, managed healthcare or related fields and educational disciplines; and,
- Thorough knowledge of the fundamentals of health insurance administration and standards, regulations and laws applicable to health insurance operations, knowledge of business and human resources administration principles, management functions, management processes and functions of health insurance departments, and experience directing and supervising personnel.
Licensure and/or Certification Required
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
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