Senior Finance Manager, Medical Expense & Reporting

Medica; Madison (WI); On-site; USD 100,000 - 172,000; Full time

Job summary

Medica is seeking a Finance Leader to oversee the month-end close of the Fully-Insured Medica Legacy business, ensuring accurate claims processing, reserves, and regulatory reporting. The role involves leading and developing a team, coordinating CMS filings, and managing intercompany activities.

Ideal candidates will have a strong analytical mindset, experience supervising teams, and the ability to drive improvements across GL and platform migrations.

Qualifications

• Bachelor's degree in related field or equivalent experience.
• 6 years of experience.
• Prior supervision experience.

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, 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.
• 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.

Skills

Analytical skills

Attention to detail

Leadership

Team development

Education

Bachelor's degree or equivalent

Job description

Medica is seeking a Finance Leader to oversee the month-end close of the Fully-Insured Medica Legacy business, ensuring accurate claims processing, reserves, and regulatory reporting. The role involves leading and developing a team, coordinating CMS filings, and managing intercompany activities.

Ideal candidates will have a strong analytical mindset, experience supervising teams, and the ability to drive improvements across GL and platform migrations.