Mlr Financial Services

The Chief Financial Officer (CFO) is the top financial executive for Blue Cross Bue Shield of Wyoming (BCBSWY), a small, mission-driven nonprofit, corporate health plan health plan of approximately 315 employees operating solely within the State of Wyoming. Reporting to the CEO and working with the Board of Directors as requested, the CFO owns the financial strategy, health, and integrity of the organization and is a hands-on leader as well as a strategist. This is an executive role that sets direction and represents the organization to regulators, auditors, lenders, and partners, while also leading a lean finance team and remaining close to the day-to-day mechanics of accounting, tax, treasury, reserves, budgeting, and reporting. As a nonprofit corporate health plan, the plan measures success by its ability to serve members and sustain the mission—generating operating margins sufficient to protect solvency and reinvest in the community rather than to distribute profit.

The role operates within the distinctive economics of a risk-bearing health plan: revenue is driven by member enrollment and premium, the largest cost is medical claims, and profitability and reserves are governed by the medical loss ratio (MLR), medical cost trend, and disciplined reserve setting. The plan is a single-state, Wyoming-based insurer regulated by the Wyoming Department of Insurance, and it works with the CMS on the plans/programs it serves. (The organization launched a Medicare Advantage product in the past 2 years through a separate joint venture; that entity is governed and reported separately, as noted above.) The CFO must balance margin and mission against statutory capital, solvency, and regulatory requirements while sustaining the confidence of the Board, regulators, and community partners.

KEY RESPONSBILITIES

Financial Strategy & Leadership: financial strategy that sustains the plan's margin, reserves, and mission; advise the CEO and Board on the financial implications of enrollment, product, network, and market decisions, serve as a hands-on financial leader for a small organization—setting direction while remaining close to the close, the budget, and the numbers—and build and mentor a lean, capable finance team, and evaluates growth and sustainability opportunities appropriate to the plan's scale, product or service-area expansion, partnerships, and financing.

Medical Economics, Reserves & Actuarial Partnership: Partner with the plan's actuary (in-house or consulting) on premium rate development, rate filings, and financial advocacy with the Wyoming Department of Insurance and CMS, ensure the adequacy and integrity of claims liabilities, including incurred-but-not-reported (IBNR) reserves and premium deficiency reserves, with appropriate documentation and independent review, owns the financial management of medical loss ratio (MLR) and medical cost trend; work with clinical, network, and operations colleagues to manage medical expense and improve forecast accuracy, oversees risk-adjustment revenue integrity, including encounters submission and reconciliation and risk-score accuracy, and monitor minimum-MLR rebate exposure under program requirements, and proactively engages with actuarial team members to analyze complex data patterns, align predictive models with long-term corporate goals, as well as facilitate unified financial insights.

Accounting, Controls & Financial Reporting: Oversees the accounting function and the timely, accurate monthly close under both U.S. GAAP and statutory accounting principles (SAP) as promulgated by the NAIC, directs the preparation and filing of statutory financial statements (the NAIC Annual and Quarterly "Orange Book" filings) with the Wyoming Department of Insurance, along with the organization's IRS Form 1120 and other required financial filings with CMS, maintains a strong internal control environment appropriate to the plan's size, and coordinate the external financial, statutory, and single (Uniform Guidance) audits as applicable, serving as the primary liaison to the Board's Finance & Audit Committee.

Capital, Solvency, Treasury & Investments: Manages statutory capital and surplus and monitor the risk-based capital (RBC) ratio to keep the plan well above required regulatory action levels, directs treasury, liquidity, and cash management; manage banking, any debt or financing, and relationships with lenders, and oversees the investment portfolio within statutory guidelines and Board policy, and manage reinsurance and other risk-transfer arrangements that protect a smaller plan against adverse claims experience.

Planning, Analysis & Performance: Leads the annual budget, multi-year financial plan, and rolling forecasts; drive variance analysis and timely corrective action, develops practical KPIs and Board-level reporting covering membership, per-member-per-month (PMPM) revenue and cost, MLR, administrative (G&A) expense ratio, days cash on hand, and margin by product, and partners with operations to manage administrative costs, staffing models, and vendor spend with the discipline a smaller plan requires.

Regulatory, Risk & Compliance: Ensures compliance with applicable financial regulations, including ACA/MLR requirements, Wyoming solvency and reserve standards, CMS and State of Wyoming program financial requirements, and the organization's tax obligations (IRS Form 1120 and 32 state forms), serves as a principal financial point of contact for the Wyoming Department of Insurance, CMS, external auditors, and the Board, maintaining credibility and transparency, and stewards the organization's reserves and community-benefit resources consistent with its nonprofit, corporate health plan mission and fiduciary duties, and support enterprise risk management across financial, operational, and vendor risk.

QUALIFICATIONS

Education: Bachelor's degree in Finance, Accounting, Economics, or a related field required; MBA, Master's in a related field, and/or CPA strongly preferred; CFA or actuarial exposure a plus.

Experience: 10+ years of progressive financial leadership experience, including a top finance role (CFO, VP/Director of Finance, or Controller ready to step up) within health insurance, managed care, or a risk-bearing healthcare organization. Working command of health plan economics: premium revenue, medical cost trend, MLR management, IBNR and reserve setting, and risk adjustment. Experience with statutory accounting (SAP), NAIC reporting, and risk-based capital, and with a state insurance regulator—State Department of Insurance and CMS experience preferred. Nonprofit, corporate health plan financial experience, including fund/reserve stewardship for the Caring Foundation. Comfort operating in a small, resource-conscious organization where the CFO is both strategist and hands-on operator across accounting, treasury, and reporting, plus familiarity with Wyoming and Rocky Mountain markets and programs (Medicare Advantage) is a plus.

Knowledge, Skills & Abilities: Technical — Solid knowledge of GAAP and statutory accounting, financial modeling, reserve analysis, and capital and solvency management. Able to translate financial and actuarial concepts clearly for the Board, regulators, and non-financial colleagues. Strong executive presence and communication, with the versatility to lead strategy and roll up sleeves in a lean environment. Effective people leader and team builder who can develop a finance staff and manage external partners (auditors, actuaries, banks). High integrity, sound judgment, and mission orientation, with the ability to operate in a highly regulated environment.

POSITION FYI:

• Reports to: Chief Executive Officer (CEO); also works the Board of Directors (BOD) the Finance & Audit Committee, and Investment Committee as may be requested by the CEO and the BOD.
• Department: Finance
• Organization type: Nonprofit, corporate health plan
• Organization size: Approximately 315 employees; operates solely within the State of Wyoming (Rocky Mountain Front Range region)
• Direct Reporting Functions: General Accounting, Tax, Payroll, Financial Planning, Finance Operations, Investment, and Treasury; partners with in-house actuary.
• FLSA status: Exempt
• Location: Wyoming; on-site with WFH flexibility
• Scope note: The organization's Medicare Advantage product is offered through a separate joint venture (JV). This CFO role may serve in an Officer for the JV; those duties are governed by a separate job description and are intentionally excluded from this document, which covers the nonprofit, corporate health plan's core CFO role only.

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