Medicare Advantage Revenue Finance Senior Director at Cigna in Nashville, Tennessee

Job Description:

The Medicare Advantage Revenue Finance Lead plays a crucial role in enabling the success of our highly complex and regulated Medicare Advantage business which is a key pillar of our enterprise growth strategy (Public commitment on growing 10%-15% annually for the next 5yrs). This individual will lead a transformation of our risk score tracking and projection methodologies inclusive of evaluating, and if needed altering, the tools, processes, and talent model needed to implement and sustain identified improvement opportunities. Furthermore, this individual will deepen connectivity with Operations partners within the Stars and Risk Adjustment Operations Team to ensure potential program changes are proactively evaluated and subsequently tracked through Finance Projection Cycles and actual results. The team also contributes to month-end close operations and is responsible for setting mid-year and final settlement accruals. The skill sets needed to be successful leading this highly analytical team will be inclusive of: Drive for Results, Drive Vision and Purpose, Manage Complexity.

RESPONSIBILITIES:

• Collaborate with finance and business leaders to drive favorable revenue results. Ensure alignment between operating goals and financial plans.
  
  
  
  • Partner with Stars & Risk Adjustment Operations leaders to develop multi-year revenue strategies and ensure revenue projections incorporate forward-looking star rating expectations and clinical documentation improvement plans. Set a point estimate, but ensure clarity on the range and likelihood of various outcomes.
  
  
  • Partner with Stars and Risk Adjustment leadership to assess the financial impact of potential business actions and influence the prioritization of those which are most impactful.
  
  
  
  


• Oversee the development of 'closest to the pin' Part-C revenue estimates for future periods. Ensure key assumptions are clearly identified, supported, and are consistent with other components of the financial projection (e.g. consistency in morbidity assumptions between claims and revenue).
  
  
  
  • Communicate variances and actionable insights to senior business and finance partners. Incorporate learnings into future projections.
  
  
  • Lead the team to set mid-year and final settlement accruals for all open payment years. Requires tight alignment with Risk Adjustment operations and Compliance teams.
  
  
  • Ensure transparency in key FP&A assumptions with business partners.
  
  
  
  


• Establish strategy and processes for best-estimate risk score projections which fully contemplate changes in customer mix and changes in key operating measures (e.g. alignment with prospective exam rates, retrospective chart reviews, etc.).


• Ensure full compliance with all SOX controls and testing.


• Partner with the analytics and IT teams to ensure Project Paragon meets all Finance data needs.


• Lead a team of financial and actuarial leaders. Manager of managers, responsible for the development of all team members

REQUIREMENTS:

• Bachelor's degree in Actuarial Science, Finance, Accounting, or other related field


• 10+ years of extensive experience in Healthcare, Financial Analysis, or related area


• Prior experience with risk adjustment strongly preferred


• Ability to communicate with Senior Leaders, on both technical and non-technical aspects of the business


• Capacity to find alternatives and solutions as well as identify problems


• Excellent judgment, communication, interpersonal and organizational abilities

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 155,300 - 258,900 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.