Astrana Health

Actuary

• Own contract modeling across MA, Medicaid, and Commercial business
• Craft sophisticated deal models to support contract negotiations with health plans
• Use data and analytics to improve financial and operational performance of health plan contracts
• Track, analyze, forecast, and report on the financial impact of payer contracts
• Build analytical infrastructure, reports, and dashboards to monitor payer financial performance
• Research legislation, market share, Star Ratings, bid strategies, and reimbursement trends
• Conduct analyses related to benchmarking, contract optimization, investor relations, and risk adjustment
• Collaborate with Reserving, Analytics, Data, Finance, M&A, Contracting, Medical Economics, and Operations teams
• Report to the Senior Manager, Actuary

Senior Analyst – Actuary

Medical Billing and Coding

• Conduct high-volume chart reviews to identify coding gaps, trends, and opportunities for improved provider accuracy
• Translate chart-review findings into actionable insights
• Create and deliver education to providers and practice leaders
• Navigate complex conversations regarding coding and documentation
• Track and report key performance metrics, including HCC recapture rates, AWVs, and other KPIs
• Review provider documentation and medical records to verify Medicare Advantage, Affordable Care Act (ACO), and Commercial risk-adjustment requirements
• Deliver individual and group provider education for managed IPAs
• Review medical records retroactively and prospectively to identify, assess, monitor, and document claims and encounter coding information related to HCCs
• Perform code abstraction and coding quality audits to ensure accurate ICD-10-CM coding and clinical-documentation support
• Interact with physicians regarding coding, billing, documentation policies, procedures, and ambiguous documentation
• Prepare and perform auditing analysis and provide feedback on noncompliance
• Maintain knowledge of coding regulations, compliance guidelines, ICD-10 and HCC updates, and payer requirements
• Recommend process improvements, root-cause analysis, and barrier resolution for Risk Adjustment initiatives
• Train, mentor, and support new employees
• Provide peer-to-peer guidance and support coder training and orientation
• Assist with or lead projects and higher work volumes than Risk Adjustment Coding Specialist I
• Travel to provider offices twice weekly in the Houston area

Risk Adjustment Coding Specialist II

Sales

• Drive membership and savings growth for Astrana’s Accountable Care Organization business
• Build relationships with independent primary care practices and local partners to establish and expand Astrana Health’s network in new markets
• Support growth in existing markets
• Recruit practices to participate in government value-based care contracts
• Potentially onboard practices into the ACO program operationally
• Achieve annual growth targets
• Develop personal territory plans with the Senior Director
• Develop new relationships and conduct outbound prospecting and inbound lead response
• Evaluate prospective practices and secure participation commitments
• Build rapport with clinical and business staff and deliver financial benefits analyses
• Explain Astrana Health’s ACO LEAD and MSSP programs
• Negotiate participation agreements
• Track leads, deals, and prospecting activity in the CRM
• Participate in weekly sales calls and pipeline reviews
• Establish and manage strategic growth plans using data to prioritize prospects
• Onboard recruited practices and support them until longer-term operations are established

Associate Director – Value-Based Care Sales

• Drive membership and savings growth for Astrana’s Accountable Care Organization business
• Build relationships with independent primary care practices and local partners to expand the network in new and existing markets
• Recruit practices to participate in government value-based care contracts
• Potentially help onboard practices into the ACO program operationally
• Work with the Senior Director to understand go-to-market strategy and develop territory plans
• Develop new relationships and engage prospective practices consultatively to secure participation
• Build rapport with clinical and business staff, understand needs, explain Astrana Health, deliver financial benefits analyses, and present ACO LEAD or MSSP opportunities
• Conduct outbound prospecting and respond to inbound leads
• Extend and negotiate participation agreements
• Track prospecting activity, leads, and deals in the CRM; participate in sales calls and pipeline reviews
• Develop strategic growth plans, use data to prioritize prospects, and execute initiatives to achieve growth goals
• Onboard recruited practices and support them until the longer-term operational plan is established
• Achieve annual growth targets

Business Development Rep

• Drive top-of-funnel growth and new partner acquisition for Astrana Health’s Accountable Care Organization initiatives
• Conduct outbound prospecting, lead generation, and meeting development with physician groups, independent practices, and healthcare organizations
• Analyze market dynamics, provider landscapes, and competitive positioning to identify high-value partnership opportunities
• Evaluate prospective providers for strategic fit, growth potential, and alignment with value-based care objectives
• Prioritize outreach based on market needs, organizational goals, and potential return on investment
• Recommend target markets, provider segments, and outreach strategies to leadership
• Develop and execute targeted outreach strategies
• Lead initial engagement discussions and present value-based care offerings and partnership opportunities
• Tailor messaging based on provider type, size, and market conditions
• Build and maintain relationships with key stakeholders
• Own and manage a pipeline of prospective ACO partners
• Advance, pause, or deprioritize opportunities based on evolving business needs
• Lead follow-up strategies and engagement plans through the pipeline
• Manage lower-complexity opportunities through later sales-cycle stages as appropriate
• Collaborate with Network Management, Operations, and Clinical teams
• Contribute to proposal development, partnership structuring, and engagement approaches
• Provide insights on provider needs, market trends, and competitive dynamics
• Analyze outreach effectiveness, pipeline conversion trends, and engagement outcomes
• Improve messaging, targeting, and engagement tactics
• Provide data-driven recommendations to enhance ACO growth performance
• Conduct in-person meetings, site visits, and presentations with prospective provider partners
• Represent Astrana Health at industry events, conferences, and networking opportunities
• Serve as a market-facing representative for brand awareness and relationship development
• Report to the Senior Director of ACO Growth

Business Development Representative – ACO Growth

• Drive top-of-funnel growth and new partner acquisition for Astrana Health’s Accountable Care Organization initiatives
• Conduct outbound prospecting, lead generation, and meeting development with physician groups, independent practices, and healthcare organizations
• Analyze market dynamics, provider landscapes, and competitive positioning to identify high-value partnership opportunities
• Evaluate prospective providers based on strategic fit, growth potential, and alignment with value-based care objectives
• Prioritize outreach and engagement efforts based on market needs, organizational goals, and potential return on investment
• Recommend target markets, provider segments, and outreach strategies to leadership
• Develop and execute targeted outreach strategies
• Lead initial engagement discussions and present value-based care offerings and partnership opportunities
• Tailor messaging and engagement approaches to provider type, size, and market conditions
• Build and maintain relationships with key stakeholders
• Own and manage a pipeline of prospective ACO partners
• Advance, pause, or deprioritize opportunities based on evolving business needs
• Lead follow-up strategies and engagement plans through the pipeline
• Independently manage lower-complexity opportunities through later sales-cycle stages when appropriate
• Collaborate with Network Management, Operations, and Clinical teams
• Provide input into proposal development, partnership structuring, and engagement approaches
• Provide insights on provider needs, market trends, and competitive dynamics
• Analyze outreach effectiveness, pipeline conversion trends, and engagement outcomes
• Improve messaging, targeting, and engagement tactics
• Provide data-driven recommendations to enhance ACO growth performance
• Conduct in-person meetings, site visits, and presentations with prospective provider partners
• Represent Astrana Health at industry events, conferences, and networking opportunities
• Serve as a market-facing representative supporting brand awareness and relationship development
• Report to the Senior Director of ACO Growth

Manager

• Comply with Case Management Department policies and procedures
• Achieve 95-100% compliance with Utilization Management health plan delegation standards for Case Management
• Utilize Milliman Care Guidelines criteria for transition of care, skilled nursing needs, and acute rehabilitation placement recommendations
• Collaborate with hospitalists, case managers, and discharge planners to establish discharge plans upon admission
• Coordinate initial and concurrent reviews through medical record review and provide accurate daily inpatient admission reporting to leadership
• Review medical records and supporting documentation to determine medical necessity, appropriateness, and level of care
• Assess, plan, implement, coordinate, monitor, and evaluate services with the goal of reducing hospital readmissions
• Attend and coordinate case management meetings on-site and off-site as required
• Communicate determination outcomes to providers and members in accordance with regulatory and accreditation requirements
• Respond to provider and interdepartmental inquiries while demonstrating exceptional customer service
• Maintain productive relationships with health plans, hospitals, and medical directors and assist with issue resolution
• Report daily activities, trends, and concerns to Case Management leadership

Inpatient Case Manager, LVN/RN

• Manage clinical services, including oversight of clinical policies, procedures, and daily activities of clinical team staff
• Ensure adequate staffing and effective workload distribution
• Train team members to serve populations with chronic physical and behavioral health conditions and various disabilities
• Train Integrated Clinical Services staff on NCQA and HEDIS measures and processes
• Ensure compliance with state and federal regulations, including HIPAA
• Liaise with other business units regarding emergency management policies and processes
• Monitor procedures and outreach/intervention efforts for positive patient outcomes
• Ensure appropriate care planning, education, and interventions for at-risk members
• Coordinate information exchange between behavioral health and medical providers for comprehensive care plans
• Monitor data related to quality measures, trends, provider issues, service gaps, and patient needs
• Evaluate care management programs and implement improvements

Care Management Manager

Navigator

• Contact patients and family members about SNF at Home options, eligibility, and enrollment
• Educate patients and caregivers about skilled nursing-level care in the home
• Serve as a point of contact throughout the transition process
• Conduct outreach and follow-up communications
• Coordinate transitions from hospitals or traditional SNFs into the SNF at Home program
• Collaborate with clinical teams, case managers, discharge planners, SNF staff, and internal team members
• Facilitate communication among patients, families, providers, facilities, and stakeholders
• Assist with scheduling, transition planning, follow-up, and enrollment coordination
• Identify transition barriers and escalate concerns
• Conduct in-person visits at hospitals and Skilled Nursing Facilities throughout Rhode Island
• Build relationships with discharge planners, case managers, SNF personnel, and healthcare providers
• Represent the organization during onsite meetings and care transition activities
• Document patient interactions, outreach, transition activities, and coordination notes
• Track outreach, enrollment progress, and transition outcomes
• Support reporting, workflows, administrative processes, team meetings, training, and special projects

Home Navigator

Operations

• Support operational projects across Las Vegas clinics, including project planning, coordination, tracking, follow-up, and status reporting
• Maintain project trackers, dashboards, worklists, and reporting tools to monitor operational performance, deliverables, deadlines, and outreach activity
• Assist with workflow reviews, process improvement initiatives, standard operating procedures, and implementation of new operational processes
• Compile, organize, and validate data from approved systems for leadership reporting and operational decision-making
• Coordinate with clinic managers, providers, medical assistants, front office staff, and corporate partners on assigned initiatives
• Support cross-functional projects improving clinic efficiency, member experience, and operational performance
• Perform outbound member outreach for empanelment initiatives, Annual Wellness Visit scheduling, preventive care efforts, and approved quality campaigns
• Use EHRs and scheduling systems to identify appointment availability, coordinate scheduling, and document outreach
• Support PCP assignment and empanelment workflows; review member lists, identify attribution or scheduling needs, and escalate issues
• Maintain documentation of outreach activities, scheduling outcomes, and member engagement efforts
• Report on contact rates, appointments scheduled, unresolved issues, and barriers to care
• Support member access, engagement, and continuity of care initiatives
• Support clinical teams with non-clinical coordination activities, work queues, patient lists, records requests, scheduling, and internal handoffs
• Escalate issues requiring clinical review or leadership intervention
• Support Network Growth initiatives during AEP, OEP, SEP, and other membership growth activities
• Assist with member outreach campaigns, PCP alignment, appointment capacity tracking, clinic access reviews, and operational readiness
• Collaborate with Operations and Network Growth teams on newly attributed and newly enrolled members
• Identify and communicate access barriers, scheduling constraints, and operational challenges affecting onboarding and retention
• Maintain accurate records and documentation; ensure compliance with organizational policies, HIPAA, and applicable healthcare regulations
• Participate in team meetings, training activities, and assigned operational initiatives
• Perform other duties and special projects as assigned

Healthcare Operations Coordinator

Full-stack Engineer

• Own the architecture, reliability, and technical direction for a product surface or system
• Ship full-stack features end to end, from schema and API through React UI
• Decompose larger problems into parallelizable work and adjust as requirements evolve
• Design durable data models and reliable integrations
• Use SQL to analyze eligibility, claims, and quality data; build reporting and analytics
• Run schema and data migrations safely, including backfills, staged cutovers, and rollback plans
• Add meaningful logging, alerts, and runbooks
• Build authorization, audit trails, and PHI minimization into designs
• Work directly with product managers, practice managers, and clinicians
• Handle production incidents independently
• Mentor junior and mid-level engineers and conduct educational code reviews

Senior Software Engineer

Accounting Manager

• Lead the end-to-end accounting function for Astrana Health's Care Delivery segment
• Own the general ledger, chart of accounts, monthly close, balance sheet substantiation, and period-end reporting
• Oversee revenue recognition for clinics and ancillary operations under ASC 606
• Own intercompany and intersegment accounting, including pricing support, recording, and consolidation eliminations
• Lead hospital accounting for Foothill Regional Medical Center, including receivables, allowances, inventory, capital projects, fixed assets, and provider fee programs
• Support consolidation, variable interest, primary beneficiary, goodwill, and long-lived asset impairment conclusions
• Own lease portfolio accounting under ASC 842
• Lead and develop the Care Delivery accounting team
• Design and maintain SOX 404 internal controls and oversee remediation
• Drive close acceleration and standardization across Care Delivery entities
• Lead accounting integration for newly acquired clinics and ancillary service lines
• Partner with Revenue Cycle to reconcile billing, collections, adjustments, patient accounts receivable, and the general ledger
• Prepare and review segment financial statements, variance analysis, and executive commentary
• Coordinate external audit, internal audit, and regulatory relationships
• Drive automation and efficiency opportunities across the segment

Director – Accounting, Care Delivery

• Set technical direction for the owned technical domain
• Make and defend architecture and infrastructure choices considering cost, operational burden, hiring implications, exit cost, and capability
• Build core components of new systems, reference implementations, and tooling
• Evolve existing systems through decomposition, strangler patterns, deprecations, and migrations
• Design for failure domains and define recovery paths for partner-feed failures, vendor API deprecations, and regional outages
• Own the modeling, joining, and serving of eligibility, claims, clinical, and quality data for product and analytics use
• Establish and drive adoption of cross-cutting standards for schemas, service templates, CI/CD, environments, and test data
• Turn recurring incidents into structural fixes
• Manage technical debt as a portfolio
• Run technical interviews, calibrate hiring and promotion decisions, and develop senior engineers
• Communicate difficult technical issues clearly to engineering and non-engineering leadership
• Work hands-on across the stack while reporting to the Head of Engineering - Applications

Staff Software Engineer

• Research and draft technical accounting memoranda on complex, non-routine, and first-instance transactions
• Apply relevant US GAAP guidance and document facts, alternatives considered, and conclusions reached
• Maintain the accounting policy manual and monitor new FASB and SEC pronouncements
• Support acquisition accounting under ASC 805, including purchase price allocations, opening balance sheets, contingent consideration, and measurement-period adjustment schedules
• Coordinate with third-party valuation specialists
• Assist with consolidation analysis, variable interest entity assessments, and non-controlling interest documentation
• Maintain technical accounting checklists for acquisitions, revenue, quarterly reporting, and significant transactions
• Prepare supporting documentation for external audit and regulatory review
• Support design and documentation of internal controls and prepare evidence for SOX 404 testing
• Help onboard acquired entities into the control framework through walkthroughs, narratives, and readiness documentation
• Assist with technical disclosures in Forms 10-K and 10-Q, including footnotes and MD&A sections
• Support external audits with organized documentation for critical audit matters
• Partner with Controllership, SEC Reporting, FP&A, and Legal
• Participate in training and knowledge-sharing efforts across the finance team

Senior Analyst – Actuary

Risk Adjustment Coding Specialist II

Associate Director – Value-Based Care Sales

Associate Director – Value-Based Care Sales

Business Development Representative – ACO Growth

Business Development Representative – ACO Growth

Inpatient Case Manager, LVN/RN

Care Management Manager

Home Navigator

Healthcare Operations Coordinator

Senior Software Engineer

Director – Accounting, Care Delivery

Staff Software Engineer

Senior Accountant – Technical Accounting