Senior Financial Specialist, Managed Care *hybrid*

WakeMed; Raleigh (NC); On-site; USD 85,000 - 120,000; Full time

Job summary

WakeMed invites applications for a Senior Financial Specialist, Managed Care to drive financial analysis of managed care contracts and reimbursement performance in Raleigh. You will develop models, validate payments, and deliver reporting to guide negotiations and optimization efforts.

The role emphasizes partnering with leaders, enhancing data accuracy, and contributing to audits and special projects that strengthen financial performance across the system.

Qualifications

• Bachelor's degree in Accounting is required; Finance is preferred.
• 4+ years in accounting/finance with emphasis on reimbursement.
• Experience with managed care contracts and revenue cycle processes.

Responsibilities

• Analyze managed care contract performance and develop financial models to support negotiations and strategic decisions.
• Validate claim payments, investigate reimbursement variances, and identify opportunities to improve financial performance.
• Maintain financial reporting tools and databases to ensure accurate, reliable analysis.
• Partner with leadership and stakeholders to provide actionable insights and support revenue optimization initiatives.
• Contribute to audits, contract reviews, and special projects that drive operational and financial improvements.

Skills

Managed care

Reimbursement

Financial analysis

Revenue cycle

Contracts

Education

Bachelor's Degree in Accounting

Bachelor's Degree in Finance

Job description

Overview

At WakeMed, our mission is to improve the health and well-being of our community—and we do it by delivering outstanding, compassionate care.

The Senior Financial Specialist, Managed Care is responsible for analyzing managed care contract performance and providing financial insights that support strategic decision-making. This role develops financial models, performs reimbursement analyses, validates claim payments, and produces reporting used for contract negotiations, audits, and revenue optimization. The position also maintains key financial databases, investigates payment variances, and supports special projects that enhance organizational financial performance.

What You'll Do

• Analyze managed care contract performance and develop financial models to support negotiations and strategic decisions.
• Validate claim payments, investigate reimbursement variances, and identify opportunities to improve financial performance.
• Maintain financial reporting tools and databases to ensure accurate, reliable analysis.
• Partner with leadership and key stakeholders to provide actionable insights and support revenue optimization initiatives.
• Contribute to audits, contract reviews, and special projects that drive operational and financial improvements.

Who You Are

• Experienced healthcare finance professional with expertise in managed care, reimbursement, and claims adjudication.
• Strong analytical skills and comprehensive knowledge of revenue cycle and contracts.
• Proficient in financial reporting systems, databases, and healthcare reimbursement methodologies.
• Collaborative partner with excellent communication and problem-solving skills.
• Detail-oriented and committed to accuracy, operational excellence, and achieving organizational financial goals.

Department Description

Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.

EOE

Licensure

Not Applicable

Education

Bachelor's Degree Accounting Required - And Bachelor's Degree Finance Preferred

Experience

4 Years Accounting/Finance - Accounting and Financial Analysis Or Accounting/Finance - Financial Analysis Or Accounting/Finance - Reimbursement Required