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Manager, Client Funding and Operations

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POST DATE 9/13/2016
END DATE 10/29/2016

Tufts Health Plan Watertown, MA

Watertown, MA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree


Under the direction of the Director of Finance Operations, this position is responsible for the management of multiple and complex ASO Client Funding arrangements and processes. The role is highly visible due to the financial interaction with the ASO client segment, representing over half of Tufts Health Plan's membership. Ensure the timely and accurate invoicing and funding of healthcare costs exceeding $25M weekly. Oversee the timely and accurate reconciliation and release of weekly provider payments exceeding $50M. Ensure financial and administrative controls are in place for all financial transactions. Oversee all Finance Operations processes including regulatory payments and reporting. This position will be responsible for integrating all new strategic initiatives in support of the business. This position requires a strong business acumen and analytical discipline. This cross functional role acts as a departmental subject matter expert (SME) and interacts with internal operational departments, sales team, external clients and business partners.

* Manages the timely and accurate completion of ASO Client Funding processes for various funding arrangements. Responsible for the weekly and monthly invoicing processing, client banking, and client funding reporting. Ensure accurate financial client reporting is developed and distributed timely. Responsible for the resolution of all production and reporting issues to ensure the accuracy of funding requests. Resolve escalated or complex funding issues by working with Sales, Legal and/or the employer group. In addition, act as SME on RFP's and complex case implementations as needed. Responsible for the communication of ASO funding processes and requirements to self-funded Clients, brokers and consultants, and the training of internal Sales team.

* Oversees various Finance Operations processes, including the management and reconciliation of the weekly provider check runs, biweekly pharmacy payments and all vendor payments. Responsible for identifying and resolving production and reporting issues. Ensures all regulatory payments and reporting requirements are met accurately and timely. Identifies and implements opportunities for system and process enhancements by working with business partners in Claims, Legal and IT. Responsible for the administration for on-line banking functions and ensuring accurate transactions for all claims related bank accounts.

* Oversees the accurate and timely completion of A/R transactions processing, and accounting reconciliations and reporting. Manages the monthly A/R close for multiple companies and ensures accurate financial reporting is provided to Accounting and business partners. Responsible for the timely resolution of all G/L reconciling items related to ASO Funding including Cash and A/R Clearing accounts, and evaluate process improvements related to financial reporting.

* Responsible for the implementation of new and complex ASO Client Funding arrangements, new vendor programs and changes, and all other corporate initiatives. Develops and implements business components of key strategic initiatives. This includes working in collaboration with Business Analytics to document business requirements, complete required testing, and develop reporting. Responsible for onboarding all new ASO account clients by working with Sales leadership and participating as a key contributor on the implementation team. Represents Finance Operations as SME in interdepartmental workgroups to ensure all financial reporting and operational requirements are met.

* Support, coach and train staff on an ongoing basis as needed to ensure a smooth functioning and high performing department. Mentor, motivate and develop staff to obtain maximum performance. Facilitate regular staff meetings to share knowledge of new processes, procedures and corporate directives. Provide training and performance feedback and reviews.

* Perform other responsibilities as required, including responding to internal and external audit requests, documenting policies and procedures, and assisting in departmental/projects as needed.

EDUCATION: (Minimum education & certifications required)

* Bachelor's degree in accounting or business administration required.

EXPERIENCE: (Years of experience)

* Minimum five to seven years of accounting or finance work experience which demonstrates the abilities to perform in the position. Reporting and analytical experience required. Managed health care experience is preferred
* Minimum three years of Supervisory experience.

SKILL REQUIREMENTS: (Include interpersonal skills)

* Must be highly motivated individual with excellent organizational skills to manage large volumes of information and multiple assignments.
* Proven ability to operate in a fast-paced environment and have the flexibility to adapt to changing processes and timelines.
* Must be able to interpret complex business situations and understand the Financial Operations implication, and work with multiple systems.
* This position requires independent judgment and the ability to make timely and sound decisions, and to work autonomously.
* Must possess excellent critical thinking and problem solving skills, and demonstrated experience with analytical work.
* Technical expertise in Excel and database applications is required. Cognos reporting is strongly preferred.
* This position must be able to work collaboratively with all levels of staff and management.
* This position frequently interacts with Clients by phone and in person.
* Excellent verbal and written communication skills are required.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)

* The Finance Department is a fast paced environment.
* This position consistently is meeting multiple demands and deadlines.
* Additional hours are required to meet the responsibilities of this role.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled


Founded in 1979 as a non-profit health maintenance organization (HMO), Tufts Health Plan is one the country's largest HMO offering a full array of healthcare coverage options to individual consumers and employer groups. Tufts Health Plan has received high marks for its quality from a variety of third parties including U.S News & World Report and Newsweek.