Highmark Health

Director Market Segment Finance

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Company :

Highmark Inc.

Job Description :

JOB SUMMARY

*This role is hybrid to Pittsburgh, Camp Hill or Buffalo - 3 days a week in office

This leadership role is responsible for directing the financial planning, forecasting, reporting, and performance analysis activities supporting the Commercial Segments business. The position leads a team of finance professionals and serves as a key business partner to segment leadership, providing financial insights and strategic guidance to support business performance, growth objectives, and achievement of current and long-term financial commitments.

The role oversees the monthly financial close process, development of operating and financial forecasts, budget planning, and analysis of key drivers of financial performance, including revenue, claims, operating expenses, membership, and profitability. Working closely with cross-functional partners across actuarial, underwriting, product, accounting, and operational teams, this position helps evaluate business opportunities, develop financial business cases, support pricing and profitability decisions, and identify actions that drive financial and operational performance.

The individual collaborates with Commercial Segment leaders to translate business strategies into financial plans, monitor performance against targets, and drive initiatives that improve earnings and operational effectiveness. Success in this role requires strong analytical capabilities, strategic thinking, and the ability to influence decisions in a highly matrixed environment.

This role also champions continuous improvement and innovation within the finance function by leveraging emerging technologies, automation, advanced analytics, and AI-enabled tools to streamline processes, improve efficiency, and deliver deeper, more actionable business insights that support faster and better decision-making.

ESSENTIAL RESPONSIBILITIES

  • Performs management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
  • Plans, organizes, staffs, directs and controls the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
  • Functions as a member of the team responsible for developing vision and strategy. Provides detailed guidance on the preparation of all financial components of the strategic plans across the business segment. Oversees communication of strategy and vision to management and staff and to representatives of the company.
  • Accountable for activities required to maintain financial records, the preparation of financial statements, the preparation of Board of Director statements, and the preparation of statutory reports for submission to the Department of Insurance in various states.
  • Leads the business segment department operating expense oversight, including maintenance of budget development processes and assessment of operating effectiveness with respect to current and multi-year financial performance targets.
  • Oversees the detailed, multi-year earnings improvement initiatives under the direct and indirect control of the segment leadership, including measurable initiatives across all Profit & Loss (P&L) categories.
  • Partners with actuarial functions, enabling effective product pricing, in-year claim analysis, and incurred but not recorded reserve decision making.
  • Oversees compliance matters including product filings, resolution of regulatory issues, responses to regulatory inquires, for a variety of products and programs marketed across the United States. Provides counseling/advice with respect to regulatory developments in the external environment, product development issues, and the interpretation and administration of Commercial Markets products.
  • Provides oversight of the business segments initiatives, ensuring that initiative business cases are thoroughly documented and that measurable success criteria are contemplated in current and multi-year budgets, projections, etc.
  • Other duties as assigned or requested.

REQUIRED EDUCATION

Bachelor's Degree- Finance, Accounting or other related field.

PREFERRED EDUCATION

Business Administration, Finance, Accounting or other related field.

EXPERIENCE

Minimum:

  • 7+ years' progressive management experience in finance or accounting.

Preferred:

  • Healthcare payer industry experience, preferably supporting Commercial insurance products and markets.
  • Experience leading Financial Planning & Analysis (FP&A) functions, including budgeting, forecasting, strategic planning, and financial performance management.
  • Experience supporting business segment P&Ls and analyzing key drivers of revenue, claims, operating expenses, membership, and profitability.
  • Experience partnering with senior executives on strategic initiatives, financial modeling, and business case development.
  • Demonstrated success leading teams and influencing decision-making in a highly matrixed organization.
  • Experience utilizing financial systems, business intelligence tools, automation, advanced analytics, and AI-enabled technologies to improve efficiency and enhance business insights.
  • Experience building and leading a high-performing team of finance professionals

KNOWLEDGE, SKILLS & ABILITIES

  • Ability to analyze financial results and to comprehend complex rating structures impacting financial results and used for financial forecasting
  • Effectively interact with all levels of management, which includes strong written and verbal communication skills and the ability to concisely explain financial principles and practices
  • Must be detail-oriented and possess strong organizational and analytical skills
  • Ability to work in a matrixed organization/environment

PREFERRED LICENSURE

CPA

TRAVEL REQUIREMENT: 0% - 25%

PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
Position Type:

Office-Based

Office-Based Positions

An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.

ADDITIONAL INFORMATION

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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