Finance Manager / Managed Care Financial Analyst The purpose of the Finance Manager / Managed Care Financial Analyst is to support the financial operations of the IPA/MSO by managing capitation reconciliations, IBNR analysis, claims payment oversight, utilization financial reporting, and risk-based healthcare financial operations. This position is responsible for monitoring financial performance across health plans, providers, and delegated arrangements while ensuring accurate reporting, payment processing, and analysis related to managed care operations, risk pools, and healthcare expenditures. The role supports leadership with financial modeling, forecasting, reconciliation, and operational finance activities to improve organizational performance and financial stability.
JOB TYPE & WORK ENVIRONMENT
- On-stie -- Alhambra, CA
- Full-time
EXPERIENCE REQUIREMENTS
Required Experience
- 3–4 years of healthcare finance or managed care financial operations experience required.
- Experience in an MSO, IPA, medical group, managed care organization, health plan, or delegated healthcare environment.
- Experience managing or analyzing IBNR reports and healthcare claims financial data.
- Experience processing and reconciling capitation payments and provider payment reports.
- Experience reviewing healthcare claims payments, utilization reports, and financial variances.
- Experience with healthcare financial reporting, budgeting, forecasting, and reconciliation processes.
- Experience working with Medicare Advantage, Medi-Cal, or managed care financial operations.
- Experience analyzing healthcare claims, encounters, eligibility, and membership data.
- Experience using Microsoft Excel, financial reporting tools, and healthcare databases.
- Experience communicating with health plans, providers, finance teams, and operational departments.
- Understanding of healthcare reimbursement methodologies, risk arrangements, and delegated models.
Preferred Experience
- Experience with QuickCap, healthcare claims systems, or managed care platforms.
- Experience with IBNR forecasting and reserve analysis.
- Experience with risk pool settlements and financial reconciliations.
- Experience supporting health plan audits and financial reporting requests.
- Experience with SQL, Power BI, Tableau, or healthcare analytics platforms.
- Experience supporting capitation and shared savings models.
- Experience in delegated risk environments and value-based care organizations.
KNOWLEDGE, SKILLS & ABILITIES
- Strong understanding of healthcare finance, managed care operations, and IPA/MSO financial workflows.
- Strong knowledge of capitation payments, IBNR, claims payments, utilization reporting, and healthcare reimbursement methodologies.
- Understanding of Medicare Advantage, Medi-Cal, delegated risk, and value-based payment models.
- Strong analytical, financial modeling, and problem-solving skills.
- Ability to identify financial variances, trends, and operational risks.
- Excellent organization, time management, and attention to detail.
- Ability to manage multiple priorities and deadlines in a fast-paced healthcare environment.
- Strong written and verbal communication skills.
- Advanced proficiency in Microsoft Excel including pivot tables, VLOOKUPs, formulas, and financial reporting functions.
- Proficiency in Outlook, Word, healthcare financial systems, and reporting platforms.
- Ability to work independently and collaboratively with operational, claims, and executive leadership teams.
- Ability to maintain confidentiality and comply with HIPAA and healthcare financial data requirements.
EDUCATION
- Bachelor’s degree in Finance, Accounting, Healthcare Administration, Business Administration, or a related field required.
PREFERRED CERTIFICATIONS
• Certified Healthcare Financial Professional (CHFP) preferred.
- Certified Healthcare Financial Professional (CHFP) preferred.
- Certified Public Accountant (CPA) preferred.
- HFMA certifications preferred.
- Advanced Microsoft Excel or financial analytics certifications preferred.