Kaiser Permanente Medical Benefit Ratio Reporting Director in Oakland, California
The Director, Medical Benefits Ratio (Director Finance) is a key financial and regulatory reporting leader. This position will work closely with the regional Controllers and regional CFOs, program office actuaries, Marketing, Sales, Service & Administration leadership, Decision Support leadership, and Corporate Controller department personnel to ensure a seamless, efficient and effective Medical Benefit Ratio development, monitoring, and reporting process.
The HealthCare Reform Act of 2010 mandated the annual reporting of Medical Loss Ratios and the administration of a rebates administration program. Kaiser Permanente, for purposes of internal communication, has adopted the term Medical Benefit Ratio (MBR) as a more appropriate and descriptive term for -Medical Loss Ratios-.
Principal Responsibilities: Lead a highly matrixed, multi-functional work team to maintain, enhance, manage and complete the work plan for MBR reporting and rebates administration, to ensure that KP meets all regulatory requirements. Evaluate, design and manage an end to end process for MBR reporting to achieve key objectives of: timeliness; accuracy; completeness consistency; compliance; and auditability. Report periodically to the MBR sponsors and other internal stakeholders on the status, risks, milestones and deficiencies of the MBR and rebates administration processes. Maintain and publish MBR metrics. Periodically inform and educate internal stakeholders about emerging trends in MBR regulations, rebates administration and enforcement activity. Partner with MBR sponsors and stakeholders to develop and publish national policies on line of business reporting, MBR reporting and rebates administration. Support development of corrective action plans in response to identified deficiencies in MBR reporting;review and approve plan for sufficiency; follow up to ensure corrective action by accountable parties. Participate in the evaluation of the need for new controls in compliance with the company-s SOX program. Manage annual MBR certification program to support final MBR filing. Partner with MBR sponsors and regional controllers to enhance MBR training programs that meet the needs of the company.
Partner with Government Relations personnel to engage governmental representatives in advocacy and solutioning with respect to bringing forward the best information for MBR reporting, per public policy and per KP's integrated system.
This position reports to the VP Deputy Controller
Essential Functions: - Leads management team to establish strategic plans and objectives for the function; may assist with developing some cross-functional oriented objectives. - Has overall control of planning, staffing, budgeting, managing expense priorities, performance requirements, and recommending and implementing changes to methods. - Influences the development and execution of functional KP-wide policies and long-term goals. - Participates in development of methods, techniques and evaluation criteria for projects, programs, and people for the corporate function.
Qualifications: Basic Qualifications:
Experience - Minimum five (5) years of management experience. - Minimum ten (10) years of related experience. Education - Bachelor's degree in related field.
Additional Requirements: - Requires expert knowledge of own area of functional responsibility and advanced knowledge of multiple related functions. - Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications: Master's degree preferred.
Enthusiastic leader focused on developing team member talent including building leadership and analytical skills.
COMPANY Kaiser PermanenteTITLE Medical Benefit Ratio Reporting DirectorLOCATION Oakland, CAREQNUMBER 614377
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.