Senior Director, Financial Operations, Actuarial Strategy

Emory University

. Own the financial infrastructure, controls, and operational oversight for Emory Health Plan's medical, pharmacy, and administrative costs .

Posted 10/12/2026full-timeRemote • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in financial infrastructure management, regulatory compliance, and vendor financial oversight within healthcare finance. Proficient in IBNR reserve management, financial reporting, and team leadership to drive operational excellence.

Highest-signal resume keywords

Financial Infrastructure ManagementRegulatory ComplianceIBNR Reserve ManagementVendor Financial ManagementTeam Development and Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Financial ControlsFinancial ReportingAccounting MethodologyClaims Lag AnalysisPharmacy Rebate AccountingContract Financial ReviewBudget ProcessesInvoice ReconciliationPayment Integrity OversightOperational Analysis

Soft Skills

Performance ManagementLeadershipCommunication

Certifications & Qualifications

CPA

Industry Keywords

Health Plan FinanceManaged Care FinanceSelf-Funded Plan RegulationsERISAHIPAAACAConsolidated Appropriations ActMental Health Parity

About the role

Key responsibilities & impact

Own the financial infrastructure, controls, and operational oversight for Emory Health Plan's medical, pharmacy, and administrative costs
Build and sustain financial operating systems, reporting cadences, budget processes, vendor financial controls, and regulatory compliance frameworks
Own vendor financial management
Direct Third Party Administrator and Pharmacy Benefits Manager invoice reconciliation, payment accuracy controls, and payment integrity oversight
Oversee vendor financial performance, contract compliance, unit cost trends, and administrative fee performance
Lead contract financial review and interpretation, flagging financial risk and aligning with budget assumptions
Support senior leadership in TPA, PBM, and stop-loss carrier contract negotiations
Own the regulatory compliance function and maintain compliance programs for applicable self-funded plan regulations
Oversee regulatory filings, state filings, audits, compliance documentation, and internal controls
Advise senior leadership on IBNR reserve management, claims lag analysis, and pharmacy rebate accounting
Develop and maintain IBNR reserve reporting and reconciliation processes with external actuaries
Own accounting methodology for pharmacy rebate accruals, claims runout, and complex reserve items
Participate in annual rate-setting and pricing, providing financial inputs and operational and claims-based analysis
Provide financial inputs for stop-loss reporting and benefits design financial modeling
Manage and develop a team, including hiring and directing additional staff

Requirements

What you’ll need

Bachelor's degree in accounting, finance, health administration, business administration, or a related field required
9+ years of progressive experience in health plan finance, managed care finance, or related healthcare financial operations
Demonstrated depth in financial controls, reporting, and accounting
CPA or equivalent accounting credential strongly preferred
Master's degree in business administration, health administration, or a related field preferred
Knowledge of self-funded plan regulations, including ERISA, HIPAA, ACA, Consolidated Appropriations Act transparency, and Mental Health Parity requirements
Experience with IBNR reserve management, claims lag analysis, pharmacy rebate accounting, financial controls, reporting, accounting, regulatory filings, audits, and vendor financial management
Ability to manage and develop a team, hire and direct additional staff, and provide performance management

Benefits

Comp & perks

Regular full-time employment
Remote work classification: Full Remote – Monthly
Occasional supported visits to an Emory University location
Equal opportunity employment
Reasonable accommodations for qualified individuals with disabilities