Job Summary

This position is responsible for overseeing all financial operations within the overall CareOregon (CO) financial policies and strategy. This position has oversight of revenue cycle and other fiscal activities and participates in accounting activities within Housecall Providers and CareOregon. This position is also responsible for strategic business and payor contract modeling, as well as identifying opportunities for improved fiscal performance. Primary duties include technical and operational leadership and planning, as well as resource and people management. This position is a key member of Housecall Providers' senior leadership team, working closely with the Chief Executive Officer, Chief Medical Officer, Chief Clinical Officer, and other members, as well as CareOregon leadership, on organizational strategic planning, ongoing strategic decision making, and overall stewardship of the organization's mission and vision.

Essential Responsibilities

Technical/Operational Leadership

Finance:

• Leads all strategic and tactical accounting and financial-related activities including budgeting, variance reporting and financial strategic planning for Housecall Providers lines of business in collaboration and coordination with CO.
• Participates in developing new revenue streams, assisting in identifying new funding opportunities, and determining cost effectiveness of prospective service delivery.
• Builds and maintains an optimal fiscal structure that includes financial practices, policies, and procedures that ensure compliance with all regulatory requirements, are consistent with CO policies and procedures, are adaptable to evolving business needs and ensures we can effectively measure and continually improve upon fiscal performance.
• Conducts financial analyses and develops business pro formas to support new payment models, grant applications, and service expansions; develops and maintains financial models to support payer contracting, budgeting, and forecasting processes.
• Coordinates with CareOregon's Accounting Department to ensure appropriate financial reporting, including assuring that revenues are accurately recognized in the proper period, collections and cash receipts are timely and properly recorded and all payments are made in a timely manner.
• Directs and oversees the preparation of monthly, quarterly, and year-end management reporting packages for all Housecall Providers entities.
• Assists in the timely and accurate completion of all external financial reporting requirements, such as DMAP and CMS filings or reports for all Housecall Providers entities.
• Assists in the preparation of IRS, state, and local tax filings.
• Develops internal systems and measures to ensure effective, efficient, and compliant financial operations in coordination with the CO Accounting team.
• Works closely with CareOregon Finance Department staff to manage Housecall Provides fiscal responsibilities.
• May serve as a sponsor or business owner for key projects and initiatives.

Contract Development:

• Provides assistance to Sr Manager of Business Development in the creation of complex contractual and financial agreements with payers.
• Regularly reviews payor contracts and works in collaboration with the CEO, Sr Business Development Manager, and payors to negotiate increase payment rates.
• Proposes alternative payment models with sound rationale by creating service-based reimbursement scenarios.
• Oversees effective implementation of payment models to support delivery system transformation in partnership with other organizational leaders.
• Develops and oversees payer reporting dashboards to assure continuation of alternative payment models.
• Works with leadership and contract staff in evaluating contract language, terms, and requirements.

Revenue Cycle Oversight:

• Provides oversight of billing, receivables, and collections operations.
• Oversees all revenue cycle and finance compliance functions and ensures the organization is following all regulatory guidelines in coding, billing, and collections.
• Provides guidance and assists with problem solving on complex issues.
• Reviews reports on pay or denial and underpayment trends and write-off activity and oversees action to address identified issues
• Oversees development of monthly reports to monitor revenue cycle management; ensures changes are made to processes, systems, and procedures to maximize timely collection of accounts receivables.
• Remains current on billing and coding practices, as well as effective software through continuing education as needed.

Strategic/Operational Planning

• Participates in the development of vision, goals, and strategic plans for the department.
• Develops short and long-term plans and policies; oversees the development and execution of standard operating procedures.
• Provides input into the strategic plans for the organization.
• Maintains a business unit view while establishing department priorities, being cognizant of broader business unit and organizational impacts.

Financial/Resource Management

• Recommends budgets in alignment with short- and long-term plans.
• Manages resources to ensure priorities are accomplished.
• Approves resource allocations within budget, including people, finances, and timelines; make decisions on exceptions.

Employee Supervision

• Directs team(s) and establishes team direction and goals in alignment with the organizational mission, vision, and values.
• Identifies work and staffing models; recruits, hires, and oversees a team to meet work needs, using an equity, diversity, and inclusion lens.
• Identifies department priorities; ensures employees have information and resources to meet job expectations.
• Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.
• Manages, coaches, motivates, and guides employees; promotes employee development.
• Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.
• Ensures team adheres to department and organizational standards, policies, and procedures.
• Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).
• Performs supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

• Perform work in alignment with the organization's mission, vision and values.
• Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization's strategic goals.
• Adhere to the organization's policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Minimum 10 years' related work experience required, including at least 5 years' experience in financial management, delivery system revenue cycle management, financial leadership and/or health care financial analytics

Preferred

• Minimum 4 years' experience in a supervisory position
• CPA License
• Hospice or Homecare Experience

Knowledge, Skills and Abilities Required

Knowledge

• Advanced knowledge of financial operations, accounting, reporting and analysis
• Understanding of the health insurance industry, including internal and external managed care systems, products, and methods
• Understanding of provider contracting, billing and revenue cycle processes and systems for primary care, hospice and palliative care programs
• Understanding of financial structures, fiscal responsibility, and the economic impact of business decisions

Skills and Abilities

• Strong analytical and problem-solving skills; ability to develop, interpret and convey complex analyses and organizational impacts
• Ability to develop and advise on trend analysis and causes of variances
• Strong leadership skills, including the ability to effectively manage a team and influence others
• Strong verbal and written communication skills, including the ability to present effectively to external and internal stakeholders
• Skilled in how to confidently diffuse difficult situations and resolve high exposure complaints
• Consensus building skills; ability to negotiate favorable outcomes
• Ability to build and maintain professional relationships with business, community, and internal management groups
• Ability to respond timely to needs of business leaders
• Ability to lead multi-stakeholder meetings and collaboration
• Ability to balance strategic and operational thinking
• Skilled in budget management and oversight
• Advanced computer and spreadsheet skills, including MS Office suite of tools
• Advanced data, mathematical and analysis skills, as well as strong attention to detail
• Ability to make independent decisions of significant impact or consequence
• Ability to work both independently and collaboratively across the organization
• Ability to plan, prioritize and coordinate multiple projects or tasks
• Ability to adhere to organizational standards, policies and procedures

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to perform repetitive finger and wrist movement for at least 3-6 hours/day
• Ability to see, read, hear, and speak clearly for at least 6 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited to, physical and ergonomic hazards.

Equipment: General office equipment

Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.

#LI-MULTI

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.