Manager Finance
$100.3k - $172kMedica
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Analyze financial data by collecting, monitoring and creating financial models for decision support. Improve financial status by analyzing results; monitoring variances; identifying trends; recommending actions to management. Assist with annual and quarterly forecasting. Performs other duties as assigned.
POSITION SUMMARY
Lead medical expense month-end close for Fully-Insured Medica Legacy business, including claims and accrual accuracy, COB Rawlings recoveries, Plan-to-Plan and MDP/CGDP processing, Medicare Cost reporting, and Medicaid Legacy quarterly data submissions. This role requires strong analytical skills, attention to detail, and the ability to manage complex financial processes while leading and developing team members.ESSENTIAL DUTIES AND RESPONSIBILITIES
Claims & Medical Expense Management- Monitor weekly claims cycles and trends to identify variances and ensure timely processing
- Prepare and post month-end journal entries for claims activity, including paid claims, interest, IBNR,
- Reconcile and clear claims clearing account monthly; investigate and resolve timing or system-related
- Develop, review, and validate IBNR estimates and claim reserves for month-end close
- Reconcile medical expense movements to actuarial projections; analyze and explain variances
- Retrieve CMS Plan-to-Plan files, review payment calculations, ensure attestations are completed
- Record resulting receivables/payables and cash impacts in the GL
- Process Manufacturer Discount Program (MDP) and CGDP payments, projections, and accruals
- Create intercompany payables
- Maintain appropriate reserves for vendor payments
- Adjust non-claims expenses for invalid Product/Unit/DOS/Location combinations
- Support DHS Data Request preparation and MLR Filing submissions
- Support Medicare Cost Report preparation including Annual Filing, Interim Cost Reports, Budget
- Provide audit support and analytics
- Prepare Reconciliation to Actuarial Triangles, Redundancy Schedules, Claims Rollforward, and Medical Expense
- Support platform migration initiatives including testing and issue resolution
- Promote financial data enhancements and resolve system-related issues
- Bachelor's degree in related field or equivalent experience
- 6 years of experience
- Prior supervision experience
$120k - $150k
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