Manager - Capitation
Manager - Capitation
Department: Accounting
Employment Type: Full Time
Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801
Reporting To: Jessica Liu
Compensation: $100,000 - $115,000 / year
Description
Astrana Health is seeking a detail-oriented and analytical Manager - Provider Capitation to oversee the accurate and timely administration of capitation payments for our primary care provider network. This role is critical in maintaining financial integrity, ensuring accurate eligibility data, and supporting internal controls including SOX audit compliance. Youâll collaborate cross-functionally to optimize capitation workflows and support value-based care delivery.
What You'll Do:
⢠Manage monthly capitation payments to PCP and Specialty Providers, ensuring accuracy and alignment with contract terms
⢠Reconcile member eligibility and enrollment data across systems to validate payments
⢠Review and maintain capitation rate structures and implement rate changes
⢠Serve as point person for SOX audits related to capitation processes and documentation
⢠Generate provider reports and internal dashboards to monitor panel, payment, and variance trends
⢠Resolve provider payment inquiries and support education on capitation models
⢠Partner with internal teams (Finance, Contracting, Operations) to ensure data integrity and compliance
Qualifications
⢠Bachelorâs degree in Finance, Accounting, Business, or related field; Masterâs preferred
⢠5+ years of experience in managed care or healthcare finance, including capitation or provider reimbursement
⢠Strong knowledge of eligibility, capitation models, and SOX/internal control processes
⢠Proficient in Excel and data/reporting tools; experience with healthcare systems preferred
⢠Strong analytical, communication, and cross-functional collaboration skills
Environmental Job Requirements and Working Conditions
⢠This position is remotely based in the US. The home office is aligned with your department at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
⢠The total compensation target pay range for this role is: $105,000 - $115,000. The salary range represents our national target range for this role.
Apply Now
Apply Now
Department: Accounting
Employment Type: Full Time
Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801
Reporting To: Jessica Liu
Compensation: $100,000 - $115,000 / year
Description
Astrana Health is seeking a detail-oriented and analytical Manager - Provider Capitation to oversee the accurate and timely administration of capitation payments for our primary care provider network. This role is critical in maintaining financial integrity, ensuring accurate eligibility data, and supporting internal controls including SOX audit compliance. Youâll collaborate cross-functionally to optimize capitation workflows and support value-based care delivery.
What You'll Do:
⢠Manage monthly capitation payments to PCP and Specialty Providers, ensuring accuracy and alignment with contract terms
⢠Reconcile member eligibility and enrollment data across systems to validate payments
⢠Review and maintain capitation rate structures and implement rate changes
⢠Serve as point person for SOX audits related to capitation processes and documentation
⢠Generate provider reports and internal dashboards to monitor panel, payment, and variance trends
⢠Resolve provider payment inquiries and support education on capitation models
⢠Partner with internal teams (Finance, Contracting, Operations) to ensure data integrity and compliance
Qualifications
⢠Bachelorâs degree in Finance, Accounting, Business, or related field; Masterâs preferred
⢠5+ years of experience in managed care or healthcare finance, including capitation or provider reimbursement
⢠Strong knowledge of eligibility, capitation models, and SOX/internal control processes
⢠Proficient in Excel and data/reporting tools; experience with healthcare systems preferred
⢠Strong analytical, communication, and cross-functional collaboration skills
Environmental Job Requirements and Working Conditions
⢠This position is remotely based in the US. The home office is aligned with your department at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
⢠The total compensation target pay range for this role is: $105,000 - $115,000. The salary range represents our national target range for this role.
Apply Now
Apply Now