Apply online at http://www.alohacare.org/Careers/Default.aspx

The Company:

AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.

The Culture:

AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.

AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.

The Opportunity:

The Financial Planning and Analysis Data Manager will play a crucial role in strategic financial decision-making and operational efficiency. Reporting to the Director of FP&A, this individual will lead AlohaCare’s strategic financial planning and analysis activities. This individual will work collaboratively across departments to improve operational efficiency, analyze financial performance, and drive the overall financial success of the organization.

Primary Duties and Responsibilities:

Strategic Planning and Financial Analysis:

• Serve as a subject matter expert to a team of finance professionals, offering informal mentorship and sharing best practices to enhance team expertise and to cultivate a high-performance culture.
• Develop and execute complex calculations for provider incentives under P4P and other quality programs, including shared savings and value-based purchasing initiatives, ensuring accuracy and alignment with organizational goals.
• Support the design and implementation of shared savings and value-based purchasing initiatives, applying financial expertise to drive cost containment and improve program efficiency.
• Develop the financial forecast and annual operating budget for the company, including monthly/quarterly reforecasting and variance analysis.
• Lead efforts to develop and enhance the Finance data warehouse, ensuring robust architecture, data integrity, and optimized reporting capabilities to enable enterprise-wide financial analysis and decision support.
• Lead the calculation and reconciliation of State risk share settlements on a quarterly and annual basis, ensuring accuracy, compliance, and timely delivery.
• Develop detailed drill-down analysis to provide actionable insights to the Medical Economics Workgroup for cost of care and administrative expense initiatives.
• Support annual negotiations with DHS MED-Quest to ensure adequate capitation rates.
• Deliver analysis of core product financial indicators for recurring and ad hoc research.
• Assist with the preparation of internal financial and operating reports, including monthly financial statements, KPIs, Finance Committee and Board of Director reports, etc.
• Assist with the preparation of external financial and operating reports, including Quarterly and Annual regulatory (HI DOI, HI DHS MED-QUEST, and NAIC) reports.

Operational Management and Financial Reporting:

• Oversee and analyze monthly capitation-related calculations and reconciliations of provider directed payments; ensure timely processing of directed payments.
• Perform cost of care analysis, identifying key cost drivers and monitor financial trends.
• Preparation of 'Run Rate' analytical reports and reconciliation of prior period adjustments.
• Forecast and monitor the IBNR process, reconciliations of provider directed payments, and risk-sharing agreements.
• Provide comprehensive oversight to the reinsurance programs, including monthly reconciliation of reinsurance receivables, and timely processing of recoveries.
• Forecast and reconcile the various risk sharing and risk corridor agreements.
• Prepare ongoing provider risk pool statements and timely, accurate annual provider risk pool reserves and ultimately settlements.

Compliance and Risk Management:

• Assist with preparation of supporting schedules and analysis for annual financial and regulatory audits.
• Support preparation of Risk Based Capital (RBC), statutory required capital reserves, and regulatory performance bonds calculations; ensure regulatory compliance.
• Support the Medicare bid cycle by facilitating finance data requests, conducting financial analysis and data validation.
• All other duties assigned.
• Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
• Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Requirements:

• Bachelor’s degree with emphasis in business administration, mathematics, statistics, data analysis, accounting/finance or healthcare administration or equivalent combination of education and experience.

• Minimum of 10 years of professional work experience in a managed care or healthcare environment, demonstrating the ability to perform the duties required for the position.
• Experience with actuarial modeling & IBNR reserve setting, MCO rate setting process and cycle.
• Achieves results, builds trust, communicate effectively, customer and quality focused.
• Excellent interpersonal skills with the ability to communicate with all levels of the organization.
• Strong interpersonal, facilitation and leadership skills with ability to interact with various departments/ project teams.
• Excellent, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
• Ability to organize, coordinate and supervise large projects in a timely, creative and effective manner.
• Ability to solve problems, analyze, think critically, make good judgment and make fair decisions.
• Experience in project management, management reporting and analysis and excellent in building, maintaining and working with spreadsheets.
• Able to effectively and methodically implement, manage, monitor, track and/or report on assigned tasks and projects.
• Possesses excellent time management and organizational skills; is dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
• Demonstrated strong skills in providing solutions and/or troubleshooting complex accounting issues.
• Excellent leadership, communication, and analytical skills.
• Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
• Must be customer service oriented and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
• Advanced skills in analytical/reporting tools (Access, SQL, Stata, SAS, SPSS).
• Advanced skills in Microsoft Programs, including Word, Excel, Access, Outlook and PowerPoint.
• Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.

Preferred Requirements:

• Master’s degree in with emphasis in Finance or related field or equivalent combination of education and experience.
• Minimum of 15 years of experience in managed care, hospital, medical office, or equivalent.
• Experience in the Finance industry or Finance department of Healthcare industry.
• Knowledge of health research methodology, biostatistics, and medical terminology.

Mental, Physical and Environmental Demands:

• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• In office working environment.
• May require prolonged sitting- up to 4 hours.
• Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday.?

Salay Range: $90,000 - $125,000 annually

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.