Manager Finance

Medica•Minnetonka, MN

10d•Hybrid

About The Position

Medica is a nonprofit health plan serving over a million members across multiple states. We focus on personalized healthcare experiences and provider partnerships to ensure members are cared for. Our team values accountability, data-driven decisions, continuous learning, and collaboration. Our mission is to support our members and employees during important life moments. We aim to create a connected care community with coordinated, quality service where every member feels valued. This position involves analyzing financial data, creating financial models for decision support, improving financial status by analyzing results, monitoring variances, identifying trends, recommending actions, and assisting with forecasting. The role leads the medical expense month-end close for Fully-Insured Medica Legacy business, covering claims and accrual accuracy, COB Rawlings recoveries, Plan-to-Plan and MDP/CGDP processing, Medicare Cost reporting, and Medicaid Legacy quarterly data submissions. It requires strong analytical skills, attention to detail, and the ability to manage complex financial processes while leading and developing team members.

Requirements

Bachelor's degree in related field or equivalent experience
6 years of experience
Prior supervision experience
Eligibility to work in the US (no visa sponsorship offered)
Legally authorized to work in the United States at the time of application

Responsibilities

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.
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; investigate and resolve timing or system-related issues.
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, and 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 and Preliminary Models.
Provide audit support and analytics.
Prepare Reconciliation to Actuarial Triangles, Redundancy Schedules, Claims Rollforward.
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.
Participate in team meetings, leadership forums, and organizational events.