Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. Nearly five decades of experience dedicated to improving care for older adults. Work spans Medicare Advantage, fully integrated care models, primary care, and next-generation care delivery models. Commitment to combining compassion with discipline, innovation with stewardship, and growth with integrity. Belief that scale should strengthen—not dilute—our mission.
Sr. Accounting Manager (Capitation & Claims)
Location
United States
Posted
77 days ago
Salary
$125K - $181K / year
Seniority
Lead
No structured requirement data.
Job Description
Sr. Accounting Manager (Capitation & Claims)
SCAN Health Insurance
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. The Job Manages the capitation and claims accounting responsibilities to ensure accurate and timely reporting of capitation and claims expenses to support financial reporting and analysis. Oversight includes contract interpretation/analysis, capitation and claims expenses, provider shared risk pools and incentive programs, medical costs accruals, data warehouse integrity and regulatory reporting. You Will - Owns 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 controls - Evaluates new, proposed, and existing contractual agreements as it relates to payment methodologies for global, full and shared risk arrangements to support accounting and reporting - Monitors capitation rate structures and rate changes to support explanations for financial fluctuations and variances against budget and forecasts - Provides 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 analysis - Leads the team in responding to and resolving provider inquiries; supports education on capitation arrangements - Ensures monthly reconciliation of data in the data tables and cubes for capitation and claims - Reviews 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 fees - Reviews and approves balance sheet account reconciliations to ensure accuracy and completeness - Responsible for financial schedules related to capitation and claims that support the organization’s regulatory financial filings and audits - Manages interim and year-end audit requests for GAAP financial audits and regulatory financial examinations - Provides data support for annual CMS and DHCS bid processes, including capitation, shared risk pools, provider incentives, claims and other medical costs - Motivates, 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 reviews. - Drives process improvements to continuously improve processes; identifies control and/or process inefficiencies, proposes and implements enhancements Your Qualifications - Bachelor's Degree in Finance, Accounting, Business or related field - Master's Degree in Finance, Accounting, Business or related field (Preferred) - 7+ years progressive experience within finance and accounting - 5+ years of experience within managed care finance and accounting, including capitation and claims - Management 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 programs - Proficiency with accounting ERP systems, Oracle is a plus - Demonstrated process improvements and project management experience What's in it for you? - Base Pay Range: $125,400 - $181,419 Annually - Work Mode: Remote - An annual employee bonus program - Robust Wellness Program - Generous paid-time-off (PTO) - 11 paid holidays per year, plus 1 additional floating holiday - Excellent 401(k) Retirement Saving Plan with employer match - Robust employee recognition program - Tuition reimbursement - An opportunity to become part of a team that makes a difference to our members and our community every day! We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now! 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. SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. 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, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-AC1 #LI-REMOTE Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities 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. 41 CFR 60-1.35(c)
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