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WakeMed Health & Hospitals
Senior Financial Specialist, Managed Care *hybrid*
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What they do
A Financial Operations Specialist specializes in foreseeing or carrying out financial transactions or other routine operations that are influenced by compliance needs. Requires some knowledge of accounting, billing, customer service and contracts. Helps businesses and their customers resolve financial billing and reconciliation issues.
$79,222 / year median in North Carolina
-2% projected decline
Job Description
Senior Financial Specialist, Managed Care
- hybrid
- WakeMed Health & Hospitals
- 3.
Full 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 RequiredAnd Bachelor's Degree Finance Preferred Experience:
4 Years Accounting/Finance- Accounting and Financial Analysis Or Accounting/Finance
- Financial Analysis Or Accounting/Finance
- Reimbursement Required