Healthcare Analyst III

Job Description

Job Description

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. The Healthcare Financial Data Analyst supports the preparation, validation, and submission of financial and operational data required by state Medicaid agencies and other regulatory stakeholders. This role works with financial, claims, enrollment, provider, and other healthcare data to ensure submissions are accurate, complete, consistent, and delivered in accordance with established reporting requirements and timelines. The analyst will collaborate with Finance, Actuarial, Accounting, Medicaid Operations, Data/IT, and other business partners to understand reporting requirements, reconcile data across systems, investigate variances, and develop repeatable processes for regulatory reporting. Prior Medicaid reporting experience is beneficial but not required. Successful candidates will bring strong analytical and problem-solving skills, experience working with complex financial or healthcare data, and the ability to learn new reporting requirements and business processes. Key Responsibilities

Support the preparation and submission of Medicaid financial, encounter, enrollment, and related regulatory data to state agencies in accordance with established requirements and deadlines. Extract, compile, analyze, and validate data from multiple financial and operational systems to support recurring and ad hoc state reporting. Perform data reconciliations, reasonability checks, and variance analyses to identify potential data quality or reporting issues prior to submission. Research discrepancies and collaborate with Finance, Actuarial, Accounting, Medicaid Operations, IT/Data, and other subject matter experts to resolve issues. Develop a strong understanding of the source-to-submission data flow, including data definitions, calculation methodologies, business rules, and reporting requirements. Maintain clear documentation of reporting processes, data sources, assumptions, business rules, validation procedures, and issue resolutions. Assist with interpreting state reporting instructions and translating requirements into repeatable analytical and reporting processes. Respond to questions and data inquiries related to previously submitted information, including researching historical results and providing supporting documentation. Identify opportunities to improve, standardize, and automate reporting and validation processes, reducing manual effort and improving data accuracy. Support internal and external audits, regulatory reviews, and other requests by providing data, reconciliations, documentation, and analytical support. Develop working knowledge of Medicaid financing, managed care reporting requirements, and healthcare financial concepts relevant to assigned reporting responsibilities. Manage multiple recurring reporting deliverables while maintaining appropriate controls and meeting established deadlines. Required Qualifications

Bachelor's degree in Finance, Accounting, Economics, Actuarial Science, Business Analytics, Data Analytics, Mathematics, Healthcare Administration, or a related quantitative field. 5 years of professional experience in financial analysis, healthcare analytics, data analysis, accounting, regulatory reporting, or a related analytical role. Demonstrated ability to work with large and complex datasets and reconcile information across multiple data sources. Strong analytical and problem-solving skills, including the ability to identify unusual results, investigate discrepancies, and communicate findings. Proficiency with Microsoft Excel, including experience using formulas, pivot tables, lookups, and other tools for analyzing and reconciling data. Ability to interpret detailed reporting instructions and translate requirements into analytical processes. Strong attention to detail and commitment to data accuracy. Ability to organize and document analytical processes so they can be understood, reviewed, and repeated by others. Strong written and verbal communication skills and the ability to work effectively with both technical and nontechnical stakeholders. Preferred Qualifications

Experience working with healthcare claims, enrollment, provider, financial, or utilization data. Experience with SQL, relational databases, data warehouses, or business intelligence tools. Experience preparing regulatory, governmental, statutory, or other externally submitted financial reports. Familiarity with Medicaid managed care, Medicare, commercial health insurance, or other healthcare payer operations. Experience working with financial reconciliations, general ledger data, capitation payments, medical claims expense, pharmacy expense, or healthcare revenue. Experience developing automated or semi-automated reporting and data validation processes. Key Competencies

Analytical curiosity:

Looks beyond whether numbers tie and seeks to understand why results changed. Data quality mindset:

Recognizes inconsistencies, investigates root causes, and understands the importance of accurate externally reported data. Financial acumen:

Comfortable working with financial concepts and understanding relationships among revenue, medical expense, membership, utilization, and other business drivers. Process orientation:

Can take a complex or manual process, document it, and make it more repeatable and controlled. Technical aptitude:

Comfortable learning new databases, reporting tools, and data structures. Ownership and accountability:

Independently manages recurring deliverables and escalates issues appropriately. Communication:

Can explain analytical findings and data issues clearly to Finance, Actuarial, operational, and technical audiences. This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week. The full salary grade for this position is $90,500 - $155,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $90,500 - $122,835. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.

In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US:

Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.