POSITION SUMMARY: We are seeking a Director of Accounting, to be responsible for all end-to-end accounting and financial reporting processes relating to our Direct Contracting, California Commercial, MediCal, and Medicare Advantage managed care revenue and healthcare costs streams (currently around $425M annually and increasing). Reporting to our Chief Financial Officer, the Director of Accounting will be responsible for designing and executing SOX-compliant processes, establishing monthly contract reporting cadences, developing robust accounting estimates relating to variable revenue elements, and collaborating with the managed care finance team on revenue projections.
PRIMARY DUTIES AND RESPONSIBLITIES:
Designing and implementing SOX-compliant controls relating to the monthly revenue and healthcare costs process, including membership analysis, comparison of capitation amounts to contracts, month-end reconciliations, medical claims analysis and journal entry processes.
Being the subject matter expert (SME) on the underlying contracts, influencing forward-looking revenue projections, negotiating contractual revenue risk and quality adjustments, and identifying areas of future revenue contract optimization.
Documenting judgmental positions relating to the application of ASC 606 to the underlying revenue contracts and performing annual Premium Deficiency Reserve (PDR) assessments.
Partnering with internal and external actuaries to determine reasonable estimation approaches for claims expenses incurred but not reported.
Driving automation initiatives to enhance the pace and accuracy of data transfers relating to membership numbers, membership claims and pricing.
Partnering effectively across the global accounting team and with FP&A and commercial team individuals involved in forecasts and contracting negotiations.
Reviewing existing accounting policies, procedures, and operational strategies, implement improvements and establishes new ones as necessary.
Assisting in coordinating with external auditors and preparing audit schedules and other necessary documents to support both Global (SEC) and local regulatory (DMHC) reporting requirements.
Coordinating and supporting Senior Accountants’ daily tasks.
Revenue Enhancement / Recoveries:
Stop-loss / reinsurance.
Ensure claims are filed with reinsurance carriers and claims reaching thresholds are received.
Risk factors experience:
Audits of risk pool reports.
Ensures claims submitted to maximize risk adjusted factor (RAF) institutional portion risk pool revenue.
Assist with special projects as assigned.
Consistently demonstrate behaviors, conduct and communications that support Meritage’s Practices and Values of Accountability, Diversity, Integrity and Respect for others, and will seek to influence these behaviors in others.
Continuously endeavors to “raise the bar” of performance and teamwork through a focus on Innovation, Collaboration, Equality and Compassion.
MINIMUM REQUIREMENTS & QUALIFICATIONS:
Bachelor’s Degree in Accounting or related field, Master’s Degree strongly preferred, with a minimum of 7 years of directly related increasingly responsible accounting experience and a minimum of 5 years’ management experience; or equivalent combination of education and experience.
Knowledge and use of US GAAP and accounting skills, especially relating to ASC 606.
CPA or CFA qualification.
5 years+ in a healthcare environment: e.g. management service organizations, independent physicians associations, medical groups, health plans.
Familiarity with healthcare revenue contracts, healthcare accounting and medical claims estimates would be ideal but is not essential (knowledge of California DMHC regulatory requirements is a bonus).
Experience with a combination of NetSuite, Ivalua, G Suite platform, and Excel and Power BI would be advantageous.
Highly analytical with the ability to evaluate complex accounting and financial data with limited supervision.