Transform Healthcare Finance at Scale
Emory Health Plan seeks an exceptional finance leader to architect and execute a $500M growth strategy, scaling operations from $800M to $1.3B over three years. A rare opportunity to lead transformational change at one of the nation's premier academic health plans serving 63,000 lives.
As Associate Vice President of Finance reporting directly to the President of the Emory Health Plan, you'll drive financial strategy, build scalable infrastructure, and shape the future of healthcare delivery during the most dynamic period in the plan's 30+ year history. Your leadership will directly impact healthcare affordability, value-based care innovation, and population health for the entire Emory community.
What You'll Lead
Strategic Financial Leadership ($800M → $1.3B)
- Architect and execute multi-year financial strategy supporting 62% growth while maintaining fiscal discipline
- Lead annual budgeting, forecasting, and scenario planning for $1.3B health plan operations
- Serve as principal financial advisor to President and governance committee on sustainability, benefit design, and strategic investments
- Design pricing strategies, rate-setting methodology, and contribution structures balancing affordability with financial integrity
- Present quarterly to EHP Governance Committee and semi-annually to University Board
Risk Management & Actuarial Oversight
- Restructure stop-loss insurance program for $1.3B scale (specific and aggregate coverages)
- Manage $80-100M reserve fund with sophisticated incurred but not reported (IBNR) calculations and actuarial validation
- Oversee relationships with external actuaries for valuations, trends, and strategic consulting
- Conduct stress testing for catastrophic scenarios including pandemics, high-cost therapies, and market disruptions
- Evaluate captive insurance and risk retention strategies appropriate for $1B+ operations
Analytics, Utilization & Value-Based Care
- Scale analytics infrastructure from 20M to 35-40M annual claims with advanced predictive modeling and machine learning
- Perform deep-dive utilization analysis identifying cost drivers, trend decomposition, and optimization opportunities
- Expand value-based care arrangements from current baseline to $300-400M (30-35% of spend)
- Design and negotiate shared savings/risk contracts with providers including capitation, bundled payments, and ACO arrangements
- Deliver ROI on care management programs and clinical interventions with measurable outcomes
Vendor Management & Cost Optimization
- Lead negotiations with TPA, PBM, stop-loss carriers, and specialty vendors managing $50M+ administrative spend
- Generate $30-50M annual savings (3-5% of budget) through strategic contracting, plan design, and operational improvements
- Evaluate and implement innovative cost strategies: reference-based pricing, centers of excellence, direct contracting, specialty drug optimization
- Establish rigorous SLAs, performance guarantees, and vendor scorecarding for accountability
Regulatory Compliance & Governance
- Ensure full compliance with ERISA, HIPAA, ACA, CAA transparency requirements, Mental Health Parity Act, and all self-funded plan regulations
- Oversee Form 5500 preparation, PCORI fees, Medicare Part D reporting, and regulatory filings
- Lead audit preparedness and coordinate with external auditors, DOL, and regulatory agencies
- Develop compliance management system with controls, documentation, and audit trails
Transformation & Innovation
- Drive adoption of emerging technologies: AI/ML for predictive analytics, RPA for automation, cloud-based financial systems
- Lead major VBC transformation initiatives
- Champion continuous improvement using Lean/Six Sigma to optimize operations for scale
- Build data-driven culture with self-service analytics, real-time dashboards, and advanced modeling capabilities
What You Bring
Required Experience
- Bachelor's degree in Finance, Accounting, Health Care Administration or related field and 10 years of progressive financial leadership experience, including direct experience with self-funded health plans, academic institutions or integrated health systems.
- MBA, MHA, MPH or other related master's degree strongly preferred.
- CPA, CMA, FSA or ASA strongly preferred.
- Progressive healthcare finance leadership with 10+ years managing self-funded health plans (50,000+ lives) or health plans with $500M+ annual spend
- Proven track record leading through significant growth or transformation (50%+ revenue/membership increase within 3-5 years)
- Deep expertise with academic medical centers, integrated health systems, Fortune 500 self-insured employers, or managed care organizations
- Direct experience negotiating and managing stop-loss/reinsurance programs for $500M+ plans
- Demonstrated success scaling value-based care arrangements to $200M+ with measurable financial outcomes
- Executive presence with board and C-suite presentation experience
Technical Mastery
- Actuarial proficiency: IBNR calculations, reserve management, trend analysis, credibility theory for large risk pools
- Claims analytics: Advanced utilization analysis, predictive modeling, risk stratification across 20M+ annual claims
- VBC contracting: Shared savings/risk design, bundled payments, capitation, quality metrics, financial reconciliation
- Financial modeling: Multi-year forecasting, scenario planning, growth modeling, contribution strategies
- Data & analytics: SQL, Tableau/Power BI, statistical analysis, machine learning applications
- Regulatory expertise: ERISA, HIPAA, ACA, CAA, Mental Health Parity, Form 5500, self-funded plan compliance
Leadership Capabilities
- Strategic thinker who translates complex financial concepts into actionable business strategies
- Exceptional communicator demonstrating leadership and cross-functional partnerships
- Change agent who leads transformation with resilience, adaptability, and coalition-building
- Team developer who builds high-performing, diverse teams and cultivates talent
- Systems thinker who sees interconnections in complex organizations and solves root causes
- Mission-driven leader passionate about healthcare improvement and population health
Key Performance Indicators
- Budget accuracy <2% variance during growth period
- Medical cost trend 200-300 bps below national benchmarks
- $30-50M annual cost savings (3-5% of budget) through optimization
- VBC portfolio scaled to $300-400M (30-35% of spend) with positive ROI
- Achieve $1.3B growth target within 3-year timeline
- Clean audit opinions with zero regulatory findings
- Stakeholder satisfaction scores 4.7+/5.0 (President, governance, HR, clinical partners)
- Team engagement in top quartile with <8% voluntary turnover
Why Emory Health Plan?
Transformational Impact
- Lead a $500M growth initiative - a once-in-a-career opportunity at this scale
- Shape the future of one of the Southeast's largest academic medical center health plans
- Drive innovation in value-based care, payment reform, and healthcare delivery
- Create lasting impact on healthcare affordability and access for 63,000+ lives
Career Acceleration
- Highly visible role reporting directly to President with board exposure
- Platform for thought leadership through publications, speaking, and industry recognition
- Unparalleled scope and complexity managing $1.3B health plan through growth period
- Experience positions you for health plan president or health system CFO roles nationally
Organizational Excellence
- Top 20 U.S. News-ranked university (#24) and #1 hospital in Georgia
- Financial strength: Emory Healthcare $8B+ annual revenue with commitment to growth investments
- Innovation culture: National reputation for clinical excellence, research, and quality
- Collaborative environment: Mission-driven culture valuing diverse perspectives
- Resources: Significant investment in analytics, technology, and capabilities
Total Rewards Package ($350K+)
- Retirement: 403(b) with 6% employer contribution + match (up to 9% total)
- Tuition remission: Full tuition for employee, 50% for dependents at Emory University (valued at $50,000+ annually)
- Time off: generous paid time off + 11 holidays plus 2 floating holidays including winter break
- Relocation assistance: for qualified candidates
- Comprehensive benefits: Premium health/dental/vision, life/disability, wellness programs, executive health
NOTE: Position tasks are generally required to be performed in-person at an Emory University location. Remote work from home day options may be granted at department discretion. Emory reserves the right to change remote work status with notice to employee.
#LI-VJ1