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Head of Medicare Segment Finance

Medica
401(k)
United States, Minnesota, Minnetonka
401 Carlson Parkway (Show on map)
Mar 13, 2025
Description

The Head of Medicare Segment Finance has overall responsibility for the financial results of their assigned business segment. This position serves as the segment finance lead and has overall responsibility for relevant financial analysis, reporting, accounting close support, forecasting, budgeting, and ad hoc analyses for running the segment. This position will be a close a strategic partner to the Segment General Manager and be jointly accountable for the successful growth and profitability of the aligned segment. This includes full oversight and accountability for the Segment P&L inclusive of membership, Revenue, Medical expense, Pharmacy expense, non-claims medical, and admin allocations for the segment.

Key Accountabilities Include:



  • Collaborate with segment leadership team to drive forward business and financial strategies to strengthen the segment's position in the market. Focus will include product, pricing, network, health management, sales, exchanges, and administrative efficiencies.
  • Represent the needs and requirements of the segment to understand and influence decisions in the development of trend reporting, cost saving initiatives, operational and platform performance and administrative efficiencies
  • Own and lead the MBR and QBR process for assigned segment. This may include updating or developing new materials to report on segment results, evaluate segment performance, provide insights on the segment business results, analyze and track opportunities for growth/profitability enhancement, and other ad hoc analysis/management reporting.
  • Evaluates financial implications of key decisions and initiatives, including major purchases, acquisitions, outsourcing arrangements, new products, IT systems development, geographic expansion opportunities, proposed new partner alignments, etc.
  • Own and lead forecasting, annual budgeting, and long-term plan development for segment financials. Regular forecasting and budgeting updates will be made throughout the year covering the entire P&L for the segment.
  • Take the lead on segment specific projects. Examples of such projects could include CMS bid development and submission, new vendor implementations, geographic expansions and/or significant platform enhancements
  • Oversee day-to-day team responsibilities and prioritize work (may include direct and indirect staff)



To be successful, this individual will also partner closely with analytics, actuarial, markets, network, and other enterprise teams as needed to effectively manage, grow, and enhance profitability for existing business or expand our existing offerings/geographical reach. Some of the key bodies of work will include: strategic planning, product pricing, product financial performance, risk management strategies, product design support, bid analysis/support, growth strategy design & execution.

Qualifications:



  • Bachelor's degree in Finance, Accounting, Economics or related field; equivalent combination of education and related work experience will also be considered
  • 10+ years of relevant combined experience in finance, accounting and/or product development
  • 5+ years direct management experience
  • Experience in finance and/or strategy in healthcare, insurance or managed care
  • Direct experience and deep knowledge of Medicare insurance business
  • Experience in budgeting, forecasting and the development of complex financial models within complex business environments / industries
  • Knowledge of applicable state and federal laws, particularly new laws related to health care reform



Skills and Abilities:



  • Strong oral and written communication and presentation skills
  • Self-directed and can develop and lead a technical team if needed
  • Ability to analyze and interpret complex financial data
  • Strong project management skills
  • Strong drive for results and accountability
  • Ability to articulate vision and strategy
  • Creative problem-solving skills using innovative approaches
  • Effective handling multiple complex projects with a high degree of engagement
  • Demonstrated leadership and influencing skills with the ability to lead and drive change
  • Strong strategic planning skills
  • Demonstrated ability to build consensus across multiple constituencies, including Senior Management
  • Collaborative management style and the ability to work with staff at all levels



      This position is an Office role, which requires an employee to work from the designated office, Minnetonka MN, on average, 2+ times per week.

      The full salary range for this director-level position is $127,800 - $219,000. 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 base compensation, this position may be eligible for incentive plan compensation in addition to base salary. 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.

      Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action 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
          The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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