Healthy Alliance

Financial Planning and Analysis

• Lead Healthy Alliance's financial strategy and operational readiness for the transition from fee-for-service and grant-dependent funding streams toward value-based, outcomes-driven, and risk-based payment arrangements.
• Develop financial models, forecasting methodologies, and performance measurement frameworks that support emerging Medicaid, social care, managed care, and population health reimbursement strategies.
• Partner with executive leadership to evaluate new lines of business, alternative payment arrangements, shared savings opportunities, capitation methodologies, and other innovative financing approaches that support long-term organizational sustainability.
• Represent the organization in all financial negotiations, reconciliation activities, rate discussions, attribution reviews, and settlement processes with Managed Care Organizations, health plans, state agencies, and other funding partners.
• Serve as the lead executive responsible for protecting Healthy Alliance's financial interests during settlement discussions, including situations where attribution methodologies, performance outcomes, eligibility determinations, or financial calculations are disputed or lack immediate consensus among stakeholders.
• Develop data-supported positions, negotiate equitable outcomes, and escalate issues appropriately while maintaining productive long-term relationships with external partners.
• Monitor and evaluate financial performance under payer contracts, value-based arrangements, government programs, and strategic partnerships.
• Identify emerging opportunities and risks related to reimbursement, Member attribution, utilization trends, quality outcomes, and contract performance.
• Advise the CEO, Executive Leadership team, Finance Committee, Audit Committee, and Board of Directors on financial implications of strategic decisions, market changes, regulatory developments, and emerging health care payment models.
• Lead PMPM reconciliation, value-based payment initiatives, financial modeling, and capacity-building reporting.
• Navigate the organization through the addition of new service lines and transition to a value-based payment (VBP) model for specific services.
• Oversee the Finance and Audit Committees of the organization, working closely with the Finance and Audit Committee Chairs, and supporting other governance committees and the board.
• Provide executive oversight of financial systems, ERP platforms, budgeting, payroll, banking, and reporting solutions.
• Ensure the maintenance of financial records and accounting systems to ensure compliance with all regulations, generally accepted accounting practices and contractual requirements.
• Provide leadership for agency-wide strategic plan implementation in partnership with the CEO and Executive team.
• Maintain strategic relationships with health systems, MCOs, community-based organizations, government agencies, auditors, consultants, and vendors.
• Oversee audit, tax, treasury, risk management, insurance, grants, and internal controls.
• Oversee development, implementation, and enforcement of financial policies and procedures.
• Perform other responsibilities and duties as assigned.

Chief Financial Officer

Executive Assistant

• Provide day-to-day support to executive leaders, including managing calendars, scheduling meetings, and helping leaders stay focused on top priorities
• Coordinate internal and external meetings, prepare agendas and materials, and track follow-up items so work continues after meetings end
• Arrange travel, complete expense reports, and support purchase requests in a timely and accurate way
• Draft, format, and review emails, letters, reports, presentations, and other materials with strong attention to detail
• Support Board and committee work by managing activities related to Board governance meetings, preparing materials, coordinating logistics, and keeping information organized and ready
• Serve as a helpful point of contact for staff, vendors, and external partners, and ensure communication is professional, timely, and clear
• Help manage office operations, including supplies, mail, vendor coordination, and general workplace needs
• Maintain accurate files, records, and documents while handling sensitive information with care and confidentiality
• Plan and support events, off-sites, team meetings, and other special activities that bring people together and support the work of the organization
• Look for ways to improve workflows, solve problems, and build systems that help the executive team and the broader organization work more effectively

Manager

• Manage incoming referrals for enhanced HRSN care management to support successful and timely connections for community members
• Provide longitudinal care management for Members receiving one or more enhanced HRSN services
• Utilize the Electronic Provider Assisted Claim Entry System/Medicaid Eligibility Verification System (ePACES/MEVS) and other data sources to confirm Medicaid enrollment and HRSN screening status, as well as existing care team management
• Conduct and document outreach to community members in alignment with required frequency, modality, and timeframe
• Manage Member consent and attestation as required throughout the screening, assessment, and care management process
• Conduct HRSN screening using the Accountable Health Communities (AHC) screening tool to assess Member HRSNs
• Conduct eligibility assessments to determine Member eligibility for enhanced HRSN services and refer Members to eligible programs and services to include enhanced HRSN services and/or existing federal, state, and local resources
• Develop Social Care Plans that include a summary of Member needs, eligibility, and services to which they are referred
• Ensure referrals are acted upon by HRSN service providers within required timeframes and redirect referrals as necessary to support service connection
• Document progress notes and action taken with each referral, as detailed in the Network Standards and Quality Program
• Update the Social Care Plan throughout service provision in collaboration with the Member and service provider to reflect strategies and interventions for meeting identified HRSNs
• Monitor and manage eligibility status changes in collaboration with Eligibility Specialists and Enhanced HRSN service providers
• Confirm service delivery completion and Member needs have been addressed satisfactorily and support the transition to additional resources
• Demonstrate ability to use various technology platforms to ensure successful and timely referral connections are made
• Maintain effective communication with internal team members, community members, and partner organizations to ensure overall coordination of care
• Collaborate with Performance team to report partner effectiveness and efficiency regarding referral response and service delivery and escalate community member service issues in a timely manner
• Regularly use data and data tools to report referral patterns and trends to the Referral Coordination Manager
• Share detailed feedback on successes and challenges of the role with the Referral Coordination Manager and continually look for opportunities to enhance and simplify the community member experience
• Effectively work in a hybrid work environment
• Some local travel may be required for meetings, community events, and other job-related responsibilities
• Demonstrate commitment to the values of diversity, equity, and inclusion
• Maintain current knowledge and understanding of Medicaid and local transformation, including New York Health Equity Reform (NYHER) 1115 Wavier Amendment, Waiver programs, Triple Aim, and value-based purchasing (VBP)
• Perform other responsibilities and duties as assigned

Chief Financial Officer

Executive Assistant

Social Care Manager