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eternalHealth Chief Financial Officer – Position Overview

Personal Note from Pooja Ika, Founder & CEO:

eternalHealth is a Medicare Advantage Plan, and similar to our other 200 or so competitors, we are also looking for a Chief Financial Officer that comes with years of Medicare Advantage experience, an understanding of STAT and GAAP accounting principles, and FP&A support, along with all the other requirements listed below, what I am really looking for is a thought-leader and partner.

Healthcare as we know it today is not sustainable, and I believe it is in the hands of the leaders today to address this and ensure that healthcare remains sustainable, affordable, and accessible to all. This is why eternalHealth’s 10-Year Goal remains.

The world is more divided now than ever before, and in our own way, we want to have a lasting impact and work to bring us all together. By demonstrating that there is enough wastage within the healthcare ecosystem, eternalHealth will be able to showcase that when optimized, we are spending enough money to fully insure the uninsured, underinsured, and immigrant populations, while still capturing savings.

With that in mind, I am looking for a CFO that understands that cost, quality, and experience matter equally, and we need to impact all of them to drive value in this industry. What differentiates us at eternalHealth is that we are actively focused on the inefficiency and wastage within the healthcare ecosystem, and before looking outward, we have committed to looking inward and first addressing the inefficiency that typically exists within health plans. Instead of operating on dozens of antiquated and fragmented technology platforms and leveraging several vendors to do their day-to-day operations, eternalHealth operates on one single cloud-based platform that embraces Robotic Process Automation, Machine Learning, and Artificial Intelligence. This allows for reduced admin costs, as eternalHealth eliminates the need for 20 to 30 vendors, the need for resources allocated to integrating the various technology platforms and captures cost savings as a result of automating close to 2,000-3,000 functions in the Medicare Advantage lifecycle. In addition to that, automation also and allows eternalHealth to remove room for human error and compliance issues that then leads to inefficiencies and waste across the healthcare ecosystem. While large health plans typically allocate 12% of their premium revenue towards SG&A on average, and Insur-Tech’s allocate over 15%, eternalHealth will only allocate 8% of its premium revenue towards SG&A by the time we reach critical membership. This allows us to take those savings and pass them onto our stakeholders like our members and providers, by enriching benefits and allocating more dollars towards the total cost of care.

I am looking for a partner who is going to think innovatively and is looking to disrupt the Medicare Advantage market, to really showcase what can be done, even when you are not the largest payer in the market. Your days will be filled with lots of ups and downs, and we will continue to think creatively and boldly every day, and your work will surpass just the financial realm, as I believe a CFO should, in order to create lasting impact. In many ways, eternalHealth is ‘The Next Generation of Medicare Advantage’, but in other ways, I want to bring back some of the original flare that health plans used to have.

Job Description

• Design and implement the financial component of eternalHealth’s overall strategy for growth and profitability, including but not limited to service area and product line expansion.
• Manage the staff of the Finance department, ensuring staff development and succession planning for all department leadership positions
• Collaborate with executive team to implement financial plans, and productivity benchmarks to monitor progress toward strategic and financial goals around MLR and ALR
• Provide proactive, sound guidance regarding management of assets and financial trends
• Oversee all elements of eternalHealth’s monthly close process
• Devise and implement accounting systems to provide complete and accurate records of plan assets, liabilities, and financial transactions
• Establish and maintain sound financial controls and record keeping; approve financial expenditures up to the level established by the CEO.
• Provide decision support of disbursements and receivables processes
• Manage eternalHealth’s investment strategy
• Manage financial audits by outside parties, preparation of financial statements, and reporting to Local, State and Federal oversight entities, regulators, system partners, executive team, and Board of Directors, in accordance with financial management and techniques appropriate to the health insurance industry
• Work with the Director of Product to ensure the integrity of CMS bid filings and coordinate with auditors and actuarial firms on relevant financial matters
• Support network department in the development, implementation, and evaluation of risk contracts
• Provide timely and accurate analysis of budgets, financial reports, and financial trends to the CEO, Audit-Finance Committee, and the Board of Directors
• Provide enterprise-wide financial leadership for Medicare Advantage risk adjustment, including RAF forecasting, budgeting, and long-term revenue planning
• Oversee end-to-end risk adjustment financial performance, ensuring accurate capture, validation, submission, and reconciliation of diagnosis data in compliance with CMS regulations
• Partner closely with clinical, analytics, coding, and operations leaders to align documentation
• Practices with financial objectives while maintaining the highest standards of compliance and ethical conduct
• Lead financial impact assessments related to CMS model changes, policy updates, coding trends, and audit outcomes (RADV, OIG, and other oversight activities).
• Own risk adjustment revenue analytics, including variance analysis, trend monitoring, and performance reporting to executive leadership and the Board.
• Guide investment decisions related to risk adjustment technology, vendor partnerships, and operational resources, with a focus on measurable ROI and sustainable margin improvement.
• Serve as a senior executive advisor on risk adjustment strategy, balancing growth, compliance, and long-term financial stability in a highly regulated environment.
• Complete all other projects and duties as assigned.

Minimum Qualifications

• MBA, MPA, MPH or equivalent advanced degree or experience
• Requires 10+ years in financial leadership roles serving Medicare Advantage health plans and working within CMS regulated landscape
• Ability to work in-person in our Boston office
• Candidate must possess an understanding of the competitive health insurance marketplace and the relevant healthcare trends with an ability to anticipate opportunities in the industry
• Strategic mindset with the ability to think critically to help the organization problem solve
• An intuitive thinker able to generate ideas and recommendations of new and/or modified approaches and understands that healthcare is not sustainable in its current form
• Demonstrated emotional intelligence, initiative, self-motivation, practical learning skills, enthusiasm and an ability to complete multiple tasks in a timely and accurate manner. required
• Demonstrated ability to operate successfully in a constantly changing, fast-paced environment
• An individual of highest personal and professional integrity, principle and knowledge, earning respect and support when making difficult decisions and choices
• Able to establish immediate credibility with peers, senior leadership, and staff
• Must listen actively and accurately, encourage input from others. Provide clear directions. Maintain an ongoing dialogue with employees to ensure continual progress and organizational improvement
• Excellent written and verbal communication skills, and analytical skills
• Ability to balance multiple projects and adapt to new issues/assignments as business needs change, comfortable with ambiguity

Licensure and/or Certification Required

CPA is preferred.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment} please contact us separately; email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”.

eternalHealth – Your Forever Partner in Healthcare and Beyond

Healthcare is confusing, but it doesn’t need to be. A consumer-centric HMO based in Boston, MA, we are a tech-focused start up that is committed to creating long-lasting partnerships with our members, our providers, and you!

About the role: As a Sales Representative with eternalHealth you will have a hand in creating a marketing and sales strategy that effectively communicates our mission, values and differentiated product. Working with external vendors such as graphic designers, call centers, and brokers you will have multiple external-facing opportunities to build relationships and build a robust, local and sustainable marketing strategy.

We provide a unique opportunity to be a part of a health plan in its beginning stages. By taking advantage of this rare opportunity, you will be able to gain insight into all the operations and expertise that is required to run a successful and sustainable plan. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and being passionate about sustainable change.

Responsibilities:

• Participate in the customer acquisition journey by developing strategies to market, nurturing leads, and ultimately increasing membership and retention.
• Work with the Marketing Team to create and implement targeted marketing strategies including advertisements, member events, promotional cycles, and product placement.
• Use data to produce actionable insights to further refine and pivot our marketing and sales strategies.
• Maintain strict privacy and confidentiality in accordance with eternalHealth’s security standards.
• Develop an understanding of the business across workstreams to be a fully flexible team player.
• Outreach specifically within targeted Massachusetts communities to promote brand awareness and local member engagement.
• Other duties as assigned.

Requirements:

• Bachelor’s degree in relevant field of study (e.g., Business Administration, Marketing, Sales, Communications, Public Relations etc.)
• Must have insurance brokers license valid in Massachusetts.
• Strong technical skills, including with Microsoft Suite (Excel, PowerPoint, Project, etc.) and other design tools, such as Photoshop, Lightroom, Illustrator.
• Excellent written and communication skills.
• Creative, strategic, and continuously striving for improvement.
• Flexible and able to ramp-up quickly on different projects to support the team as needed in a fast-paced start-up environment.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.

Preferred:

• Experience in marketing and sales, and/or in start-ups, tech, healthcare or insurance is a plus.
• Experience with healthcare operations is a plus.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process, please contact us separately, email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”.

Care Manager

eternalHealth – The Next Generation of Medicare Advantage

Healthcare is confusing, but it doesn’t need to be. A consumer-centric HMO based in Boston, MA, we are a tech-focused start up that is committed to creating long-lasting partnerships with our members, our providers, and you!

About the role: As a Care Manager with eternalHealth you will be a core member at eternalHealth – whose responsibilities will include care management. This position will work towards meeting clinical, financial and operational performance goals and standards.

We provide a unique opportunity to be a part of a health plan in its beginning stages, and you will have insight into all the operations and expertise that is required to run a successful and sustainable plan as well as build the foundation for sustainable growth that will be crucial to eternalHealth’s success. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.

Responsibilities:

• Actively perform and comprehensively document members and provider outreach and engagement activities to support complex care management, care coordination, disease management, and transitions of care.
• Perform comprehensive assessments of physical, emotional, psychosocial, and environmental needs of members and their caregivers.
• Create dynamic and fluid member-centered care plans to support health goals and improve health outcomes, continually evaluating for effectiveness.
• Ensure members receive services that align with their benefit coverage and coordinate additional resources as required for holistic care.
• Follow and contribute to eternalHealth’s strategic goals related to population health management, quality improvement, and financial stewardship.
• Must understand and maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
• Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and Massachusetts Department of Insurance (DOI) and guidelines set forth by other regulatory agencies, where applicable, and defined in eternalHealth policies.
• Other duties as assigned.

Requirements:

• Active RN License
• Bachelor’s degree in nursing or equivalent work experience.
• 3+ years of work experience in care management.
• 1+ years of Health Plan experience is preferred.
• Excellent written and communication skills.
• Creative, strategic, and continuously striving for improvement.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.
• Experience coordinating with cross-functional teams and/or external partners/stakeholders.
• Exceptional interpersonal skills with the ability to work in a fast-paced environment as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Strong technical skills, including Microsoft Suite (Outlook, Excel, PowerPoint Word, etc.) and other collaborative tools.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us separately; email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”

eternalHealth – The Next Generation of Medicare Advantage

Healthcare is confusing, but it doesn’t need to be. A consumer-centric Medicare plan sponsor based in Boston, MA, we are a tech-focused start up that is committed to creating long-lasting partnerships with our members, our providers, and you!

About the role: As a Clinical Pharmacist with eternalHealth you will be a core team member whose responsibilities will include supporting all activities in the Population Health Department. This position will work towards meeting financial and operational performance goals and standards. The clinical pharmacist is responsible for executing the daily activities associated with the clinical and operational components of the pharmacy benefit. This position reviews data, resolves issues, and coordinates tasks associated with pharmacy programs. This position also provides clinical support to interdisciplinary teams to improve healthcare outcomes, ensure patient safety, recommend cost-effective medication strategies, ensure compliance, and coordinate care efficiently and effectively.

We provide a unique opportunity to be a part of a health plan in its beginning stages, and you will have insight into all the operations and expertise that is required to run a successful and sustainable plan as well as build the foundation for the sustainable growth that will be crucial to eternalHealth’s success. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.

Responsibilities:
• Serve as subject matter expert and provide recommendations designed to address Medicare Part D associated Stars ratings
• Identify drivers of performance and cost and develop/execute plans to address those items in an effort to raise quality scores and lower plan spend
• Assist with oversight of clinical subcontractors
• Manage and oversee pharmacy benefits processing
• Assist with collaboration efforts with eternalHealth’s Third Party Administrator (TPA)
• Oversee Acumen data and report submission
• Participate in compliance and financial functions with the Medicare Compliance Officer and the Finance team
• Contribute to member and provider newsletters
• Formulary monitoring, oversight, and evaluation
• Complete comprehensive medication reviews
• Interact regularly with Population Health leadership and staff to develop and execute upon eternalHealth’s overall company direction and goals, including KPIs related to cost, quality, operations, and outcomes of member care.
• Work with a high performing team of clinical and non-clinical professionals that will deliver exceptional care while meeting quality and delivery targets.
• Follow eternalHealth’s strategic goals related to population health management and quality improvement, including developing and implementing analytics and project planning for quality measures.
• Provide support for marketing materials
• Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and Massachusetts Department of Insurance (DOI), Arizona DOI, and guidelines set forth by other regulatory agencies, where applicable, and defined in eternalHealth policies.
• Other duties and responsibilities as assigned.

Requirements:
• Doctor of Pharmacy or Bachelor of Science in Pharmacy
• Master’s degree in business administration or project management certification a plus
• 3 years of clinical experience
• 1+ years of Health Plan experience or Managed Care residency a plus
• Experience in program management and/or design or implementation
• Knowledge of CMS regulations
• Experience coordinating with cross-functional teams and/or external partners/stakeholders.
• Have knowledge around industry best practices and regulatory compliant reporting, preferred.
• Interpersonal skills with the ability to work in a fast-paced environment and health plan as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Strong technical skills, including with Microsoft Suite (Excel, PowerPoint, Project, etc.) and other collaborative tools.
• Ability to work on-site full-time at eternalHealth’s downtown Boston office or based in Arizona.
• Excellent written and communication skills.
• Creative, strategic, and continuously striving for improvement.
• Flexible and able to ramp-up quickly on different projects in order to support the team as needed in a fast-paced start-up environment.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us separately; email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”.

Care Coordinator

eternalHealth – The Next Generation of Medicare Advantage

Healthcare is confusing, but it doesn’t need to be. A consumer-centric HMO based in Boston, MA, we are a tech-focused start up that is committed to creating long-lasting partnerships with our members, our providers, and you!

About the role: As a Care Coordinator with eternalHealth you will be a core member at eternalHealth – whose responsibilities will include supporting all activities in the Population Health Department. This position will work towards meeting financial and operational performance goals and standards.

We provide a unique opportunity to be a part of a health plan in its beginning stages, and you will have insight into all the operations and expertise that is required to run a successful and sustainable plan as well as build the foundation for the sustainable growth that will be crucial to eternalHealth’s success. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.

Responsibilities:

• Support departmental activities related to quality metrics (STARs) including day to day management of related workplans
• Assist with inbound and outbound member engagement including/not limited to scheduling appointments, documentation, information about care gaps, and information sharing
• Assist with oversight of clinical subcontractors
• Assist with management of pharmacy benefits
• Assist with collaboration efforts with eternalHealth’s Third Party Administrator (TPA)
• Interact regularly with Population Health leadership and staff to develop and execute upon eternalHealth’s overall company direction and goals, including KPIs related to cost, quality, operations, and outcomes of member care.
• Work with a high performing team of clinical and non-clinical professionals that will deliver exceptional care while meeting quality and delivery
• Follow eternalHealth’s strategic goals related to population health management and quality improvement, including developing and implementing analytics and project planning for quality measures.
• Must understand and maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company
• Comply with all guidelines established by the Centers for Medicare and Medicaid (CMS) and Massachusetts Department of Insurance (DOI) and guidelines set forth by other regulatory agencies, where applicable, and defined in eternalHealth policies.
• Other duties and responsibilities as

Requirements:

• Associate or bachelor’s degree in healthcare
• Master’s degree in business administration, healthcare administration, related field, a plus. Or applicable experience in a clinical or managed care
• Experience in project management and/or design or implementation
• Experience coordinating with cross-functional teams and/or external partners/stakeholders.
• Have knowledge around Health Care/ Health Plan industry best practices and regulatory compliant reporting, a Plus.
• Interpersonal skills with the ability to work in a fast-paced environment as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Strong technical skills, including with Microsoft Suite (Excel, PowerPoint, Project, etc.) and other collaborative tools.
• Ability to work on-site full-time at eternalHealth’s downtown Boston
• Excellent written and communication
• Creative, strategic, and continuously striving for
• Flexible and able to ramp-up quickly on different projects to support the team as needed in a fast-paced start-up environment.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.
• Ability to participate at Member events/eH events throughout Massachusetts.
• Bilingual, fluent in Spanish a plus

Preferred:

Valid MA Driver’s License

A personal vehicle for travel within Massachusetts

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us separately; email HR@eternalhealth.com with the email subject “Reasonable Accommodations – Applicant Name Here”.