Job Description Summary
The Market Finance Lead will report to the VP, Operations Finance and is responsible for the financial outcomes of our value-based primary care organization, overseeing regional financial strategy and performance management. This role ensures the financial sustainability of assigned regions by aligning financial goals with patient outcomes through close dyad partnerships with regional leadership.
How will you make an impact & Requirements
Responsibilities
- Develop and execute regional financial strategies in close dyad partnership with Operational and Clinical leadership.
- Develop and present Regional Business reviews to Executive Leadership.
- Proactively identify trends and areas of opportunity within organic membership growth, clinical documentation, quality, and medical management.
- Collaborate with Healthcare Economic partners to deep dive medical expense trend and opportunities impacting assigned regions.
- Work closely with Finance partners to monitor Work RVU productivity, patient throughput, and revenue trends.
- Analyze and optimize performance in Medicare Advantage and other risk-sharing arrangements.
- Monitor key financial and operational metrics such as medical loss ratio (MLR), per-member-per-month (PMPM) costs, Work RVU production, and staffing levels.
- Identify opportunities to improve cost efficiency while maintaining high-quality patient care.
- Collaborate with clinical leadership to align financial goals with patient outcomes and population health initiatives.
- Provide insights on patient panel risk stratification, physician productivity, and care model efficiency.
- Ensure adherence to financial and compliance requirements under CMS, Medicare Advantage, and other value-based contracts.
- Implement strong internal controls to safeguard financial integrity.
- Educate physicians and operational leaders on financial drivers in value-based care.
- Demonstrate excellent guest service to internal team members and patients.
- Perform other related duties as assigned.
Qualifications
- Bachelor’s degree in finance, Business Administration, or a related field (master’s preferred).
- 5+ years of financial experience in a value-based healthcare organization, preferably in primary care or population health.
- Strong knowledge of capitation, shared savings, and risk-adjustment methodologies.
- Experience with financial analytics, financial statements, and claims data.
- Proficiency in healthcare financial systems and value-based performance tools.
- Strong strategic thinking, problem-solving, presentation, and leadership abilities.
- Excellent communication skills to engage physicians, operational teams, and executive leaders.
- Ability to navigate complex relationships across the organization.
- Ability to positively impact key Performance Indicators such as Medical Loss Ratio (MLR) optimization, Total Cost of Care (TCOC) reduction, Provider financial performance in value-based contracts, PMPM revenue and expense management and Compliance with value-based contract terms.
- Ability to work independently in a fast-paced, cross-functional environment.