Finance Manager, MassHealth Product

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It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Description

The Finance Manager, MassHealth Product will work jointly with the Director of Finance and Strategy to lead program Finance for the WellSense ACO and MCO programs under the Massachusetts Medicaid product known as MassHealth. WellSense’s MassHealth enrollment includes >500k lives across 8 different ACOs and 1 MCO throughout Massachusetts. The Manager will work with the WellSense Finance team and Population Health Services team at BMCHS and lead Finance and ACO performance discussions with our external ACO clients and the Population Health Team regarding medical expense management, quality program performance, risk adjustment, and health equity. The Senior Manager will be a key player in helping to link program outcomes back to financial performance and measuring and reporting on progress and outcomes. Manages external relationships to explain performance, uncover questions and opportunities, and help ACOs leverage financial reporting and measurements to inform local strategies and program planning. Maintains a broad understanding of MassHealth program design to identify and explain drivers of current financial performance while working in a matrixed environment with interactions with external ACO executive staff.

Our Investment In You

• Full-time remote work
• Competitive salaries
• Excellent benefits
  
  

Key Functions/Responsibilities

• Prepare, distribute, and present MassHealth financial reports to ACO partners and state agencies, incorporating latest market and risk adjustment simulations available from the state.
• Work closely with population health team to identify custom initiatives and strategies to maximize financial performance at each ACO given their unique relative performance.
• Work closely with the financial planning team to incorporate financial projections in reported financials and understand drivers of relative performance differences across our ACOs.
• Work closely with the system analytics team to help identify drivers of financial performance and performance improvement opportunities for each ACO.
• Work closely with the trend, risk adjustment and actuarial teams as needed to understand drivers of medical trend and changes in relative risk scores for each ACO.
  
  

Experience Required

• A minimum of three years of progressively responsible experience in healthcare consulting or other areas of healthcare Finance with a demonstrated ability to drive performance.
  
  

Experience Preferred/Desirable

• Five or more years of progressively responsible experience in healthcare consulting or other areas of healthcare Finance with a demonstrated ability to drive performance.
  
  

Competencies, Skills, And Attributes

• Strong oral and written communication skills; ability to interact within all levels of the organization.
• A strong working knowledge of Microsoft Office products.
• Demonstrated ability to successfully plan, organize and manage projects
• Detail oriented, excellent analytic skills. Time management skills to meet deadlines, multi-task, and prioritize projects under specific time constraints. Project management skills a plus.
• Ability to work collaboratively with a variety of business partners.
• Strong team player.
  
  

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

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