Associate Vice President, Finance - Emory Health Plan

** Discover Your Career at Emory University
** Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community.
** Description*
* ** 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 score carding 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…