REMOTE Capitation & Claim Accounting Manager
We are seeking a Contract to Hire Accounting Manager – Capitation & Claims to lead critical healthcare accounting functions. This role owns the insight behind capitation and claims accounting, supporting financial reporting, regulatory compliance, and strategic decision making.
Responsibilities Lead all day-to-day accounting operations for capitation and claims, including month-end close, P&L review, and balance sheet integrity
Interpret and analyze provider contracts and payment methodologies (global risk, shared risk, capitation structures)
Monitor capitation rate changes and financial variances, providing clear explanations vs. budget and forecast
Deliver financial analysis and insights to cross-functional stakeholders using large, complex datasets
Oversee medical cost accruals, including IBNR and related estimates
Ensure data integrity and reconciliation across financial systems, data warehouses, and reporting cubes
Review and manage provider shared risk pools, incentives, and other payment programs
Support regulatory reporting, audits, and financial filings (CMS, DHCS, GAAP audits)
Partner with internal teams to support annual bid processes and financial modeling
Qualifications Bachelor's degree in Accounting, Finance, or related field
5+ years of managed care / healthcare accounting experience
Deep expertise in: Capitation accounting
Medical claims & IBNR
Provider risk-sharing arrangements and incentives
Experience in Medicare Advantage preferred
Background in health plans, provider networks, or integrated delivery systems
Exposure to healthcare core admin systems (claims/capitation modules)
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