Manager - Capitation
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Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801

Compensation: $100,000 - $115,000 / year

Department: Accounting

Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801

Compensation: $100,000 - $115,000 / year

DescriptionAbout this Role: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. You'll 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

• Bachelor's degree in Finance, Accounting, Business, or related field; Master's 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.

Seniority level

• Seniority levelMid-Senior level

Employment type

• Employment typeFull-time

Job function

• Job functionOther
• IndustriesHospitals and Health Care

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