Efficient fund financial management is a fundamental condition for ensuring the safety of medical insurance funds and the foundation for the sustainable development of the healthcare security system. Affected by traditional administrative management thinking, the internal control environment of China's healthcare security department is weak, with functional departments acting independently, medical insurance business being detached from fund finance, which limits the performance of fund financial management functions. This article analyzes the current situation of financial management environment and financial business construction in the practice of medical insurance management, explores the relationship between management behavior and fulfillment of responsibilities by functional departments, and proposes a path for the synchronous development of medical insurance business and fund finance. It is recommended establishing and implementing a standardized internal control system, strengthening daily business guidance, cultivating high-quality medical insurance professional and technical talents, and improving the level of medical insurance management.