Managing Director, Health Care Finance Solutions
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Overview
Under the general direction of the Deputy Executive Vice Chancellor (DEVC) of Operations, ForHealth Consulting, the Managing Director, Health Care Financing Solutions (HCFS) oversees the full spectrum of activities under the HCFS division. The Managing Director of HCFS is a senior executive responsible for driving ForHealth Consulting's mission and business objectives. The position oversees all third-party liability, federal claiming, and program integrity projects, including Medicaid-related revenue recovery projects and cost avoidance activities in 14 states and the District of Columbia. ForHealth Consulting, part of UMass Chan Medical School, partners with public and private health sectors to address complex issues facing hard-to-reach, medically complex, and marginalized populations.
In Massachusetts, HCFS provides operational support to the Executive Office of Health and Human Services (EOHHS) and MassHealth (Medicaid) in areas such as Third-Party Liability, Financial and Program Compliance, Federal Claiming, statewide management of the School-Based Claiming program, Medicare Buy-in and Premium Assistance programs, and technical support for the HIX-IES initiative. HCFS also manages the State Supplement Program, conducts lab billing, and provides vaccine reimbursement services.
The Managing Director will lead the strategic and operational activities of HCFS, including developing growth strategies, identifying business opportunities, maintaining key relationships, and evaluating performance against strategic goals. The candidate should possess deep knowledge of healthcare financing in the US, excellent leadership skills, and the ability to develop stakeholder relationships.
Responsibilities
* Lead the HCFS division, ensuring alignment with organizational vision.
* Set and implement strategic directions and long-term business strategies.
* Oversee financial management, including budgeting, performance reviews, and claims preparation.
* Identify growth opportunities and develop new product lines.
* Establish KPIs and performance metrics.
* Enhance efficiency through process improvements and automation.
* Conduct SWOT analysis for risk mitigation.
* Promote services, develop client relationships, and represent HCFS publicly.
* Manage workforce development and talent retention.
* Collaborate on infrastructure and technology support.
* Ensure legal and regulatory compliance.
* Negotiate with clients on project scope, objectives, and budgets.
* Fulfill obligations of the Interagency Services Agreement with EOHHS.
* Participate in senior leadership committees.
* Perform other duties as assigned.
Qualifications
* Master's Degree in business or related field or equivalent.
* 10+ years of operational/management experience with significant budget responsibility.
* 7-9 years of experience with Medicare and Medicaid programs, federal rules, and regulations.
* Excellent communication skills, leadership, and strategic planning abilities.
* Experience managing large teams and multiple projects.
Additional Information
Seniority level: Executive
Employment type: Full-time
Job function: Finance and Sales
Industries: Online Audio and Video Media
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