Clinical Risk Manager Jobs in Madison, WI (NOW HIRING)

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Analyze financial data by collecting, monitoring and creating financial models for decision support. Improve financial status by analyzing results; monitoring variances; identifying trends; recommending actions to management. Assist with annual and quarterly forecasting. Performs other duties as assigned.

The Finance Manager, Clinical is responsible for leading financial planning, budgeting, forecasting, reporting, and financial analysis activities that support clinical operations and healthcare service delivery. This role partners closely with clinical leadership, operational teams, and executive stakeholders to ensure financial performance, regulatory compliance, cost management, and informed decision-making across clinical programs and departments.

Key Accountabilities

Financial Planning & Analysis

• Lead annual budgeting, monthly forecasting, and long-range financial planning processes for clinical operations.
• Analyze financial performance, identify trends, and provide actionable recommendations to improve efficiency and profitability.
• Develop and maintain financial models to support strategic initiatives, business cases, and operational decisions.
• Monitor clinical department budgets and provide variance analysis against budget, forecast, and prior-year performance.

Clinical Operations Support

• Partner with clinical leaders to evaluate staffing models, productivity metrics, and resource utilization.
• Assess the financial impact of new clinical programs, services, and operational initiatives.
• Support cost containment strategies while maintaining quality patient care and regulatory compliance.
• Provide financial guidance on capital investments, equipment purchases, and clinical program expansions.

Reporting & Analytics

• Prepare and present monthly, quarterly, and annual financial reports to leadership.
• Develop dashboards and key performance indicators (KPIs) related to clinical operations, labor costs, revenues, and productivity.
• Analyze reimbursement trends, payer mix, revenue cycle performance, and operational expenses.
• Deliver insights and recommendations to support data-driven decision-making.

Compliance & Controls

• Ensure compliance with organizational financial policies, healthcare regulations, and accounting standards.
• Support internal and external audits and provide required financial documentation.
• Maintain strong financial controls and risk management practices.
• Assist in implementing and improving financial processes and reporting systems.

Leadership & Collaboration

• Build strong relationships with clinical, operational, and administrative stakeholders.
• Mentor and support finance team members as applicable.
• Lead cross-functional projects involving finance, clinical operations, and organizational strategy.
• Drive continuous improvement initiatives across financial and clinical processes.

Required Qualifications

• Bachelor's degree or equivalent experience in a related field
• 7+ years of work experience beyond degree
• Advanced proficiency in Microsoft Excel and financial reporting tools.
• Strong communication, presentation, and stakeholder management skills.

Preferred Qualifications

• Master's degree (MBA, MHA, or related field).
• CPA, CMA, HFMA, or other relevant professional certification.
• Strong financial modeling, budgeting, forecasting, and analytical skills.
• Experience with healthcare reimbursement models, revenue cycle management, and clinical productivity metrics.
• Knowledge of healthcare regulatory requirements and industry benchmarks.
• Experience with ERP, EHR, and financial planning systems.
• Experience supporting clinical operations, healthcare organizations, hospitals, physician groups, or healthcare systems.

This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN or Madison, WI office, on average, 3 days per week.

The full salary grade for this position is $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $133,245. 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 compensation, 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.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity 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.