VP of Finance / Chief Financial Officer (CFO)
Location: Ontario, California (91762)
Compensation: $$225,000 - $275,000 annually, depending on experience
Position Summary
The Chief Financial Officer (CFO) is a strategic executive leader responsible for the comprehensive financial management and fiscal soundness of the organization. Reporting directly to the CEO and engaging with the Executive Leadership Team and Board of Directors, the CFO will provide critical financial insights and guidance to shape the company's overall direction, sustainability, and growth.
This executive will oversee all finance, accounting, audit, tax, budgeting, treasury, investor relations, financial planning & analysis (FP&A), risk management, and procurement functions, with a specific and deep focus on the financial complexities of the Medicare Advantage (MA) business line.
Key Responsibilities
1. Medicare Advantage Financial Leadership & Strategy
- Oversee all MA financial operations, including premium revenue modeling, CMS payment reconciliation, medical expense forecasting, and Incurred But Not Reported (IBNR) estimation.
- Lead or co-lead the financial components of the annual CMS Part C & Part D bid submission in partnership with actuarial teams.
- Ensure robust Hierarchical Condition Category (HCC) / Risk Adjustment Factor (RAF) revenue performance monitoring, reconciliation accuracy, and optimization of risk adjustment outcomes.
- Develop and maintain sophisticated encounter-based financial analytics and cost-of-care forecasting models.
2. Regulatory Financial Compliance (MA/Managed Care)
- Ensure full compliance with all state and federal financial requirements (e.g., DMHC, CMS, NAIC, Knox-Keene).
- Direct Tangible Net Equity (TNE), restricted cash, and statutory solvency planning and monitoring.
- Oversee the preparation and submission of Medical Loss Ratio (MLR), Prescription Drug Event (PDE), Direct and Indirect Remuneration (DIR), Financial Statement Report (FSR), and other required filings.
- Manage quarterly and annual statutory financial reporting and ensure perpetual audit readiness.
3. Accounting, Reporting, and Internal Controls
- Lead the timely and accurate preparation of both GAAP and statutory financial statements.
- Design and maintain strong internal controls over claims, capitation, pharmacy payments, and delegated entity disbursements.
- Oversee daily accounting operations, including premium reconciliation, reserves, and month-end/year-end close processes.
- Ensure financial processes support scalability, audit compliance, and public company-level governance standards.
4. Actuarial & Cost Management Partnership
- Collaborate closely with actuarial partners to develop financial trends, cost projections, and scenario analyses.
- Evaluate and structure shared-risk, capitation, and value-based delegated contracting models.
- Support actuarial certifications and lead cross-functional cost-containment initiatives.
5. Pharmacy, Delegated Entity, and Vendor Oversight
- Oversee pharmacy financial performance, including DIR forecasting, rebate settlements, and PBM performance management.
- Provide financial oversight and lead financial audits for all Financially Responsible Delegates (FDRs), including TPAs, PBMs, IPAs/MSOs, ensuring compliance with CMS delegation standards.
- Monitor risk-sharing settlements, capitation accuracy, and performance guarantees.
6. Treasury, Liquidity, and Capital Strategy
- Maintain adequate solvency and liquidity to support claims, capitation, reinsurance obligations, and regulatory requirements.
- Manage banking relationships, investment policies, and working capital strategy.
- Lead financial readiness for multi-year strategic planning and market expansion initiatives.
7. Leadership, Governance, and Board Communication
- Provide clear, compelling financial reports, strategic assessments, and solvency updates to the Board, Audit Committee, and executive leadership.
- Communicate complex MA financial and actuarial concepts clearly to both internal and external stakeholders.
- Build, mentor, and lead a high-performing finance team capable of supporting a growth-stage managed care operation.
Qualifications
Required Skills & Experience
- Education: Bachelor’s degree in Finance, Accounting, Business, or a related field.
- Experience: 10–15 years of progressive financial leadership experience, with at least 5 years in a VP of Finance or equivalent executive role.
- Managed Care Expertise: Deep and demonstrable experience in the financial leadership of Medicare Advantage (MAPD) plans is required, including proficiency with IBNR, MLR, CMS payment methodologies, and regulatory reporting.
- Proven track record of developing financial strategies that drive growth, profitability, and operational efficiency.
- Strong knowledge of financial software, ERP systems, and BI/reporting tools.
Preferred Credentials
- MBA, CPA, CMA, or CFA designation is strongly preferred.
- Experience with capital markets, investor relations, and public company regulatory filings (e.g., SEC).
Professional Attributes
- Exceptional leadership, people management, and team-building skills.
- Strong analytical, problem-solving, and critical thinking abilities.
- Excellent communication (verbal, written, and public speaking) and interpersonal skills.
- High integrity, a commitment to transparency, ethics, and corporate governance.
- Ability to thrive and maintain focus in a fast-paced, dynamic, and evolving environment.
Why Join This Organization?
This is a unique opportunity to join a leadership team shaping a next-generation California Medicare Advantage plan. You will be instrumental in:
- Building a Legacy: Taking the lead on the financial preparation for DMHC licensure and CMS plan launch, establishing operational excellence and long-term regional growth.
- Strategic Alignment: Working within a structure that balances the stability and governance of a publicly-affiliated entity with deep, physician-driven, local roots and a community-first mission.
- Market Impact: Leading the transformation of value-based healthcare delivery in one of the nation's most dynamic and senior-rich markets (Inland Empire/Greater Los Angeles).
