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Highmark Health Director Market Segment Finance in Pittsburgh, Pennsylvania

Company :

HM Insurance Group

Job Description :

JOB SUMMARY (Summarizes the major purpose and primary responsibilities)

This job is responsible for oversight of the financial operations of a business segment within the company and support of the direct operating expense oversight of the department. Appraises operating results in terms of costs, budgets, operational policies, trends and increased profit opportunities. Partners with segment and matrix partner leaders to drive achievement of current year and multi-year financial commitments.

ESSENTIAL RESPONSIBILITIES (Describes the critical tasks, duties and responsibilities of the position.)

  • Performs management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.

  • Plans, organizes, staffs, directs and controls the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.

  • Functions as a member of the team responsible for developing vision and strategy. Provides detailed guidance on the preparation of all financial components of the strategic plans across the business segment. Oversees communication of strategy and vision to management and staff and to representatives of the company.

  • Accountable for activities required to maintain financial records, the preparation of financial statements, the preparation of Board of Director statements, and the preparation of statutory reports for submission to the Department of Insurance in various states.

  • Leads the business segment department operating expense oversight, including maintenance of budget development processes and assessment of operating effectiveness with respect to current and multi-year financial performance targets.

  • Oversees the detailed, multi-year earnings improvement initiatives under the direct and indirect control of the segment leadership, including measurable initiatives across all Profit & Loss (P&L) categories.

  • Partners with actuarial functions, enabling effective product pricing, in-year claim analysis, and incurred but not recorded reserve decision making.

  • Oversees compliance matters including product filings, resolution of regulatory issues, responses to regulatory inquires, for a variety of products and programs marketed across the United States. Provides counseling/advice with respect to regulatory developments in the external environment, product development issues, and the interpretation and administration of Commercial Markets products.

  • Provides oversight of the business segments initiatives, ensuring that initiative business cases are thoroughly documented and that measurable success criteria are contemplated in current and multi-year budgets, projections, etc.

  • Other duties as assigned or requested.

REQUIRED EDUCATION

Bachelor's Degree- Finance, Accounting or other related field.

Substitutions (Acceptable substitutions in lieu of a degree 1 ½ years’ experience = 1 year college)

No Substitutions

PREFERRED EDUCATION

Business Administration, Finance, Accounting or other related field.

EXPERIENCE

Minimum: This section refers to the minimum years and type of applicable experience needed to perform the job. Minimum requirements must be non-comparative, objective, and relevant.

  • 7+ years' progressive management experience in finance or accounting.

Preferred: This section refers to additional desired years and type of experience that the hiring manager would prefer, above and beyond the basic requirements of the job.

  • Healthcare payer sector experience.

KNOWLEDGE, SKILLS & ABILITIES ( List the attributes required to perform the job through demonstrated service, education or training)

  • Ability to analyze financial results and to comprehend complex rating structures impacting financial results and used for financial forecasting

  • Effectively interact with all levels of management, which includes strong written and verbal communication skills and the ability to concisely explain financial principles and practices

  • Must be detail-oriented and possess strong organizational and analytical skills

  • Ability to work in a matrixed organization/environment

REQUIRED LICENSURE (Licenses that are required to perform the job)

PREFERRED LICENSURE

CPA

TRAVEL REQUIREMENT: 0% - 25%

(List % of time traveling)

LANGUAGE REQUIREMENT ( other than English )?

(List primary language)

PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS

( The physical, mental demands and working conditions described here are representative of those that must be met by an employee to successfully perform the essential function of their job. Reasonable accommodations will be made when necessary to enable individuals with disabilities to perform the essential duties of the position, to the extent that they do not cause undue hardship.

Position Type:

Office-Based

Office-Based Positions

An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.

Teaches/Trains others regularly - Constantly

Travels regularly from the office to various work sites or from site-to-site - Occasionally

Works primarily out-of-the office selling products/services (Sales employees) - Does Not Apply

Physical Work Site Required - No

Most On-The-Road Positions

An employee in this position may work in a home or company office environment but is also frequently driving to and from various locations to perform the work off-site. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.

Non-Office-Based Positions

An employee in this position is frequently required to move throughout the workplace, sit, stand and walk, use hands and fingers to hold objects, tools or controls, possess fine motor skills (e.g., to write and operate a computer or to steer transportation equipment), possess gross motor skills (e.g., to carry items), reach with hands and arms, climb stairs and ladders, balance, stoop, kneel crouch and crawl, communicate effectively, and talk and hear. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. The employee must be able to work in a busy environment where decisions often must be made quickly, must attend work on a regular and reliable basis, must adhere to all workplace policies, and may be called upon to work outside regular business hours. This work occurs in a [example: warehouse, hospital or provider’s office or mailroom].

Lifting: up to 10 pounds - Does Not Apply

Lifting: 10 to 25 pounds - Does Not Apply

Lifting: 25 to 50 pounds - Does Not Apply

ADDITIONAL INFORMATION

Changes Approved By:

Melanie Lysne

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J241887

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