Essential Functions:

• Identifies, develops, plans and executes short, medium and long-range organization and division strategies; ensures the development and implementation of associated business plans, tactics and policies.
• Oversees the allocation of capitation, risk sharing, insured-service pools and incurred but not reported (“IBNR”) liabilities associated with medical claims.
• Negotiates and along with the Compliance Officer, monitors and maintains government contracts (e.g. DHCS, CMS) and other fiscally binding contracts or agreements.
• Oversees the preparation of the annual operating, capital, and associated budgets using a zero-based budging approach; ensures monthly compliance and/or appropriate documentation and explanation of variances from budget; through subordinate staff, maintains appropriate budget controls over departmental expenditures.
• Maintains a reliable cash flow projection process and reporting mechanism that includes minimum cash threshold to meet operating needs.
• Oversees and directs the timely and accurate analysis of budgets, financial reports, medical loss analysis, and financial trends.
• Establishes and maintains bank accounts, financial controls, and business relationships required to properly administer the various financial functions of HPSJ.
• Maintains adequate insurance and reinsurance coverage.
• Oversees the internal and external audit function to ensure the timely and accurate completion of annual fiscal audits and other financial information.
• Works with DHCS to advocate for sound rate development process and rates.
• Directs timely and accurate revenue reconciliation.
• Presents clear HPSJ financial reports to the HPSJ Commission and lead the Finance and Investment (F&I) Committee of the Commission along with the F&I Committee Chair.
• Ensures consistent, efficient, accurate and timely payroll processing.
• Ensure the development, implementation and adherence to financial procurement policies that meet HPSJ’s performance needs and ensure the appropriate commitment of funds.
• Oversees the development and implementation of financial policies and procedures; confers with the Executive and Management teams to ensure effective financial management and internal controls throughout HPSJ.
• Ensures that Generally Accepted Accounting Principles (GAAP) as well as compliance with state and federal financial record keeping and reporting regulations are met such as Tangible Net Equity reserves.
• Oversees the selection, maintenance and upgrades of financial and accounting systems.
• Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
• Hires, develops and retains, and ensures that direct reports hire, supervise and retain a competent staff.

What You Bring:

Knowledge, Skills, Abilities and Competencies

Required

In-depth knowledge of the health care industry, its critical issues and major challenges.

• In-depth knowledge of managed care, Medi-Cal and other government entitlement programs.
• In-depth knowledge of state and federal regulatory guidelines as they relate to assigned areas of responsibility within a managed care environment.
• Knowledge of the economic and healthcare issues, and issues affecting the underserved in San Joaquin County and/or surrounding areas.
• Demonstrated depth of knowledge of GAAP and finance and accounting policies and procedures for not-for-profit organizations and accounting for investments.

• Basic knowledge of health care core administrative systems and their integration with financial and accounting systems.
• Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; identifies, plans, leads and executes to meet changing organizational and community needs, and regulatory requirements.
• Cultivates innovation: Creates new and better ways for the organization to be successful.
• Drives results: Consistently achieves results, even under tough circumstances.
• Drives engagement: Creates a climate where people are motivated to do their best to help the organization achieve its objectives.
• Drives vision and purpose: Paints a compelling picture of the vision and strategy that motivates others to action.
• Courage: Steps up to address difficult issues, says what needs to be said.
• Nimble learning: Actively learns through experimentation when tackling new problems, uses both successes and failures as learning fodder.
• Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations.
• Outstanding skills in and demonstrated ability to develop and manage operating budgets that support business objectives.

• Communicates effectively: Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences.
• Very strong presentation skills, with the ability to tailor presentations to a specific audience, and address and interact with large groups.
• Very strong interpersonal skills, with the ability to establish and maintain effective working relationships with diverse individuals at all levels inside and outside of HPSJ.
• Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
• Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
• Very strong collaboration skills, with demonstrated ability to create and foster a collaborative work environment, maintain effective, high-performance teams, and organize people and resources to solve problems and identify business opportunities.
• Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
• Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
• Very strong project management skills, with the ability to function as a sponsor and owner on complex projects; a track record of successful large project implementations.
• Strong customer service orientation.

• Politically astute and demonstrates a high level of personal and professional integrity and honesty.
• Ensures accountability: Holds self and others accountable to meet commitments.
• Strong knowledge of change management theory, with ability to anticipate and implement effectively.
• Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
• Very strong coaching/counseling skills, including the ability to function as a mentor to management and employees.
• Ability to supervise staff, and ensure that direct reports supervise staff, in a manner that maximizes employee performance and business results.

• Ability to treat confidential information with appropriate discretion.

What You Have:

Education and Experience

Required

• Bachelor’s Degree in Accounting, Economics or Business Administration; and
• At least four years as a CFO in a health maintenance organization; OR
• At least eight years as a controller in a health maintenance organization; and
• At least four years financial experience with MediCal or other government entitlement programs; and
• At least four years supervisory experience.

Preferred

• Master’s Degree in Accounting, Economics or Business Administration.

Licenses, Certifications

Required

• Valid driver’s license.
• 
  

Preferred

• CPA

What You Will Get:

HPSJ Perks:

• Robust and affordable medical coverage including HMO and PPO plan options
• Employee Wellness Program promoting physical, mental, and financial well-being
• Dental and vision plan with multiple provider choices
• Generous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays, and 9 paid holidays)
• CalPERS retirement pension program, automatic employer-paid retirements contributions, plus a voluntary defined contribution plan
• Two flexible spending accounts (FSAs)for healthcare and dependent care expenses
• Employer-Paid Term Life and AD&D Insurance
• Employer-Paid Disability Insurance
• Employer-Paid Assistance Program (EAP)
• Health Advocacy to help you navigate medical care and benefits
• Voluntary supplemental benefits including medical, legal, identity theft protection
• Online discount mall
• Tuition reimbursement
• Remote work contingent on business needs and company guidelines
• A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do

At this time, the Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card, or U.S. citizenship.

Physical Demands

Work may require frequent sitting, standing, and walking, constant repetitive motion, frequent talking and listening, closeup and distance vision requirements. Some work may require occasional travel based on the responsibilities of the position and business needs and occasional handling materials up to 50 pounds.

Emotional/Psychological Demands

Ability to cope with a fast-paced work environment, working under pressure, dynamic priorities and deadlines, constant decision making, working irregular hours, emotional and sensitive situations.

Work Environment

Work may be performed in a remote, hybrid, or onsite setting depending on the requirements of the position and business needs. For roles performed remotely, employees are expected to maintain a secure, distraction-free workspace, and reliable internet connectivity consistent with company standards.

Important Notice: The duties, qualifications, and physical and emotional requirements listed in this job description are not exhaustive. Health Plan of San Joaquin reserves the right to revise this job description at any time.