Job Details

ResponsibilitiesOwns all aspects of day‑to‑day accounting operations for capitation and claims, including managing the month‑end close process, reviewing P&L results, ensuring Balance Sheet integrity, and establishing accounting policies, procedures and internal controlsEvaluates new, proposed, and existing contractual agreements as it relates to payment methodologies for global, full and shared risk arrangements to support accounting and reportingMonitors capitation rate structures and rate changes to support explanations for financial fluctuations and variances against budget and forecastsProvides analytical support to Network Management, Shared Services, Value‑Based Care, and other Managed Care departments by synthesizing data from multiple sources into clear, meaningful, and concise explanations and variance analysisLeads the team in responding to and resolving provider inquiries; supports education on capitation arrangementsEnsures monthly reconciliation of data in the data tables and cubes for capitation and claimsReviews provider shared risk reports prepared by the team; collaborates with Managed Care departments (including Actuarial Services and Value‑Based Care)Manages other provider payments, including performance incentives and admin feesReviews and approves balance sheet account reconciliations to ensure accuracy and completenessResponsible for financial schedules related to capitation and claims that support the organization's regulatory financial filings and auditsManages interim and year‑end audit requests for GAAP financial audits and regulatory financial examinationsProvides data support for annual CMS and DHCS bid processes, including capitation, shared risk pools, provider incentives, claims and other medical costsMotivates, engages and develops team members by communicating job expectations, planning, providing training, developing personal growth opportunities, appraising job results, coaching, and counseling via regular 1:1's and periodic goal reviewsDrives process improvements to continuously improve processes; identifies control and/or process inefficiencies, proposes and implements enhancementsQualificationsBachelor's Degree in Finance, Accounting, Business or related fieldMaster's Degree in Finance, Accounting, Business or related field (Preferred)7+ years progressive experience within finance and accounting5+ years of experience within managed care finance and accounting, including capitation and claimsManagement level finance and accounting experience at a health insurance company, integrated healthcare system, or provider network (Preferred)Experience with Medicare Advantage (Preferred)Experience with healthcare core admin systems (capitation and claims modules) (Preferred)Deep knowledge in capitation arrangements, medical claims and IBNR, provider shared risk pools and incentive programsProficiency with accounting ERP systems, Oracle is a plusDemonstrated process improvements and project management experienceBenefitsBase Pay Range: $125,400–$181,419 AnnuallyWork Mode: RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid‑time‑off (PTO)11 paid holidays per year, plus 1 additional floating holidayExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every day!Equal Opportunity EmployerSCAN is proud to be an Equal Employment Opportunity and Affiliation Statement. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, marital status, disability, protected veteran status or any other status protected by law. A background check is required.The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41CFR60‑1.35(c)At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.#J-18808-Ljbffr