Craig Bellise
Bethpage
Summary
Finance leader specializing in Medicaid and Medicare, delivering $90M in favorable trend adjustments at Molina. Expertise in risk adjustment strategies and contract negotiation, resulting in $35M in annual cost avoidance. Skilled in strategic vision and implementation, improving payment integrity management across various healthcare settings.
Overview
29
29
years of professional experience
1
1
Certification
Work History
NY Market CFO
Molina
07.2024 - 03.2025
- In charge of the financial performance of NY Mainstream and MLTC business ($2.5B).
- Led premium rate advocacy initiatives with NYS to influence favorable prospective trend adjustments ($90M)
- Support all potential M&A opportunities for the New York market.
Assistant Vice President Finance
Molina
10.2021 - 06.2024
- Developed operational and financial infrastructure after acquisition for the following areas: PCP capitation, HCRA reporting, value-based contracting, NYS reinsurance, and NYS directed payments.
- Produce all forecasting, financial reporting, and run rate analysis for the NY market.
- Supervision of the team that produced all external NYS reporting (MLR, MMCOR, and Encounter Penalty and Premium Withhold Reconciliations).
- Earned back 100% of all withholds ($65-$70 million annually).
Vice President/Controller Finance
Affinity Plan
01.2016 - 10.2021
- Directed team responsible for all external NYS financial reporting and compliance.
- Oversaw monthly close and forecasting activities to ensure accurate financial tracking.
- Led cross-functional team managing internal and regulatory audits effectively.
- Disputed over $23 million in proposed NYS HCRA taxes for years 2015-2018.
- Established payment integrity department to guarantee accuracy of medical claims payments.
- Achieved $35 million in annual cost avoidance through enhanced claims processing strategies.
- Generated $20 million in annual post-pay claims recoveries through meticulous audits.
- Constructed revenue management department to optimize risk adjustment premiums, generating $30 million to $60 million annually.
Senior Director, Revenue Management & Gov’t Programs Finance
EmblemHealth
03.2013 - 01.2016
- Provided financial leadership for Medicare and State Sponsored lines of business, ensuring strategic alignment with annual CMS bids.
- Implemented EPIC EMR system solution for Advantage Care Physicians, creating hard/soft stops to enhance clinical workflows.
- Delivered $65 million in value through addressing quality care gaps during patient visits.
Director of Government Programs Finance
EmblemHealth
03.2008 - 05.2013
- Launched revenue management department responsible for directing operational and financial performance associated with risk adjustment premiums for all Emblem Medicare, Medicaid, and Healthcare Exchange products ($6B) safeguarding upwards of ($180M) in annual gross revenue protection.
Director of Medical Expense Accounting
HIP HEALTH PLAN of NEW YORK
01.2004 - 03.2008
- Oversaw capitation department, managing operational and financial aspects of provider contracts with yearly impact exceeding $1.6B.
- Developed quarterly claims and overhead expense reconciliation process, achieving $10M in annual savings.
- Designed mainframe-based Ancillary capitation module to calculate retroactive capitation for non-traditional business models valued at $60M.
- Collaborated with IS department to enhance Capitation Error Reporting process, improving data integrity and saving $5M annually.
- Reviewed and implemented contracts with Medical Groups to ensure service delivery for members.
- Provided detailed financial analysis to Vice President of Finance and Contract Relations.
- Conducted quarterly analysis for line of business reporting and financial statements.
Accounting Supervisor
IBBOTSON ASSOCIATES
Chicago
04.2000 - 05.2001
- Supervised staff accountant in processing accounts payable efficiently.
- Managed payroll functions for 130 employees, including timely tax filings.
- Filed monthly sales tax returns for IL, NY, TX, and AZ, ensuring compliance with state regulations.
Senior Financial Analyst/Project Manager
CHILDREN’S MEMORIAL HOSPITAL
Chicago
11.1995 - 04.2000
- Conducted monthly budget variance analysis and prepared financial statements.
- Prepared and analyzed year-end schedules for external auditors.
- Directed annual budget process for hospital with $300M in gross revenues.
Education
B.B.A. -
Dowling College
Oakdale, NYA.A.S. - Business Administration
Suffolk C.C.
Selden, NYSkills
- Business process improvement
- Value-based financial modeling
- Medicaid and Medicare expertise
- Risk adjustment strategies
- Contract negotiation skills
- Strategic vision and implementation
- Payment integrity management
Certification
- Passed CPA exam
- Certified ISO 9000 Auditor
References
References available upon request.
Timeline
NY Market CFO
Molina
07.2024 - 03.2025
Assistant Vice President Finance
Molina
10.2021 - 06.2024
Vice President/Controller Finance
Affinity Plan
01.2016 - 10.2021
Senior Director, Revenue Management & Gov’t Programs Finance
EmblemHealth
03.2013 - 01.2016
Director of Government Programs Finance
EmblemHealth
03.2008 - 05.2013
Director of Medical Expense Accounting
HIP HEALTH PLAN of NEW YORK
01.2004 - 03.2008
Accounting Supervisor
IBBOTSON ASSOCIATES
04.2000 - 05.2001
Senior Financial Analyst/Project Manager
CHILDREN’S MEMORIAL HOSPITAL
11.1995 - 04.2000
B.B.A. -
Dowling College
A.A.S. - Business Administration
Suffolk C.C.
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