eternalHealth Chief Financial Officer - Position Overview
Personal Note from Pooja Ika, Founder & CEO:
eternalHealth is a Medicare Advantage Plan, and similar to our other 200 or so competitors, we are also looking for a Chief Financial Officer that comes with years of Medicare Advantage experience, an understanding of STAT and GAAP accounting principles, and FP&A support, along with all the other requirements listed below, what I am really looking for is a thought-leader and partner.
Healthcare as we know it today is not sustainable, and I believe it is in the hands of the leaders today to address this and ensure that healthcare remains sustainable, affordable, and accessible to all. This is why eternalHealth’s 10-Year Goal remains:
The world is more divided now than ever before, and in our own way, we want to have a lasting impact and work to bring us all together. By demonstrating that there is enough wastage within the healthcare ecosystem, eternalHealth will be able to showcase that when optimized, we are spending enough money to fully insure the uninsured, underinsured, and immigrant populations, while still capturing savings.
With that in mind, I am looking for a CFO that understands that cost, quality, and experience matter equally, and we need to impact all of them to drive value in this industry. What differentiates us at eternalHealth is that we are actively focused on the inefficiency and wastage within the healthcare ecosystem, and before looking outward, we have committed to looking inward and first addressing the inefficiency that typically exists within health plans. Instead of operating on dozens of antiquated and fragmented technology platforms and leveraging several vendors to do their day-to-day operations, eternalHealth operates on one single cloud-based platform that embraces Robotic Process Automation, Machine Learning, and Artificial Intelligence. This allows for reduced admin costs, as eternalHealth eliminates the need for 20 to 30 vendors, the need for resources allocated to integrating the various technology platforms and captures cost savings as a result of automating close to 2,000-3,000 functions in the Medicare Advantage lifecycle. In addition to that, automation also and allows eternalHealth to remove room for human error and compliance issues that then leads to inefficiencies and waste across the healthcare ecosystem. While large health plans typically allocate 12% of their premium revenue towards SG&A on average, and Insur-Tech's allocate over 15%, eternalHealth will only allocate 8% of its premium revenue towards SG&A by the time we reach critical membership. This allows us to take those savings and pass them onto our stakeholders like our members and providers, by enriching benefits and allocating more dollars towards the total cost of care.
I am looking for a partner who is going to think innovatively and is looking to disrupt the Medicare Advantage market, to really showcase what can be done, even when you are not the largest payer in the market. Your days will be filled with lots of ups and downs, and we will continue to think creatively and boldly every day, and your work will surpass just the financial realm, as I believe a CFO should, in order to create lasting impact. In many ways, eternalHealth is ‘The Next Generation of Medicare Advantage’, but in other ways, I want to bring back some of the original flare that health plans used to have.
Job Description
- Design and implement the financial component of eternalHealth's overall strategy for growth and profitability, including but not limited to service area and product line expansion.
- Manage the staff of the Finance department, ensuring staff development and succession planning for all department leadership positions
- Collaborate with executive team to implement financial plans, and productivity benchmarks to monitor progress toward strategic and financial goals around MLR and ALR
- Provide proactive, sound guidance regarding management of assets and financial trends
- Oversee all elements of eternalHealth's monthly close process
- Devise and implement accounting systems to provide complete and accurate records of plan assets, liabilities, and financial transactions
- Establish and maintain sound financial controls and record keeping; approve financial expenditures up to the level established by the CEO.
- Provide decision support of disbursements and receivables processes
- Manage eternalHealth's investment strategy
- Manage financial audits by outside parties, preparation of financial statements, and reporting to Local, State and Federal oversight entities, regulators, system partners, executive team, and Board of Directors, in accordance with financial management and techniques appropriate to the health insurance industry
- Work with the Director of Product to ensure the integrity of CMS bid filings and coordinate with auditors and actuarial firms on relevant financial matters
- Support network department in the development, implementation, and evaluation of risk contracts
- Provide timely and accurate analysis of budgets, financial reports, and financial trends to the CEO, Audit-Finance Committee, and the Board of Directors
- Provide enterprise-wide financial leadership for Medicare Advantage risk adjustment, including RAF forecasting, budgeting, and long-term revenue planning
- Oversee end-to-end risk adjustment financial performance, ensuring accurate capture, validation, submission, and reconciliation of diagnosis data in compliance with CMS regulations
- Partner closely with clinical, analytics, coding, and operations leaders to align documentation
- Practices with financial objectives while maintaining the highest standards of compliance and ethical conduct
- Lead financial impact assessments related to CMS model changes, policy updates, coding trends, and audit outcomes (RADV, OIG, and other oversight activities).
- Own risk adjustment revenue analytics, including variance analysis, trend monitoring, and performance reporting to executive leadership and the Board.
- Guide investment decisions related to risk adjustment technology, vendor partnerships, and operational resources, with a focus on measurable ROI and sustainable margin improvement.
- Serve as a senior executive advisor on risk adjustment strategy, balancing growth, compliance, and long-term financial stability in a highly regulated environment.
- Complete all other projects and duties as assigned.
Minimum Qualifications
- MBA, MPA, MPH or equivalent advanced degree or experience
- Requires 10+ years in financial leadership roles serving Medicare Advantage health plans and working within CMS regulated landscape
- Ability to work in-person in our Boston office
- Candidate must possess an understanding of the competitive health insurance marketplace and the relevant healthcare trends with an ability to anticipate opportunities in the industry
- Strategic mindset with the ability to think critically to help the organization problem solve
- An intuitive thinker able to generate ideas and recommendations of new and/or modified approaches and understands that healthcare is not sustainable in its current form
- Demonstrated emotional intelligence, initiative, self-motivation, practical learning skills, enthusiasm and an ability to complete multiple tasks in a timely and accurate manner. required
- Demonstrated ability to operate successfully in a constantly changing, fast-paced environment
- An individual of highest personal and professional integrity, principle and knowledge, earning respect and support when making difficult decisions and choices
- Able to establish immediate credibility with peers, senior leadership, and staff
- Must listen actively and accurately, encourage input from others. Provide clear directions. Maintain an ongoing dialogue with employees to ensure continual progress and organizational improvement
- Excellent written and verbal communication skills, and analytical skills
- Ability to balance multiple projects and adapt to new issues/assignments as business needs change, comfortable with ambiguity
Licensure and/or Certification Required
Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth's mission, values, and compliance standards.
Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment} please contact us separately; email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”.
