Head of Management Finance

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. 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; recommending actions to management. 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.
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, and claim reserves
Reconcile and clear claims clearing account monthly; Develop, review, and validate IBNR estimates and claim reserves for month-end close
Reconcile medical expense movements to actuarial projections; Financial Close & Reporting

Retrieve CMS Plan-to-Plan files, review payment calculations, ensure attestations are completed
Record resulting receivables/payables and cash impacts in the GL
Adjust non-claims expenses for invalid Product/Unit/DOS/Location combinations

~ Regulatory Compliance & Filings

Support DHS Data Request preparation and MLR Filing submissions
Support Medicare Cost Report preparation including Annual Filing, Interim Cost Reports, Budget and Preliminary Models
Provide audit support and analytics
Prepare Reconciliation to Actuarial Triangles, Redundancy Schedules, Claims Rollforward, and Medical Expense

~ Systems & Process Improvement

Provide subject-matter expertise for GL migration activities including requirements clarification, data validation, parallel testing, and reconciliation of legacy vs new GL outputs
Support platform migration initiatives including testing and issue resolution
Promote financial data enhancements and resolve system-related issues

Conduct regular one-on-one meetings for team leadership and coaching
Bachelor's degree in related field or equivalent experience
~Prior supervision experience

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: 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. 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.
All candidates must be legally authorized to work in the United States at the time of application. 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.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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