Astrana Health

Technology-enabled platform delivering value-based care

Director of Accounting - Care Delivery

Financial AccountingUpdated on Nov 13

Full-timeAlhambra, CA, USA$160k - $200k /yrHybrid

About the Job

Requirements

A bachelor's degree in Accounting, Finance, or a related field is required; CPA is also required. An active CPA license is preferred but not required.
At least 10 years of progressive accounting experience, including leadership of multi-entity or multi-site accounting operations.
Deep knowledge of U.S. GAAP, including revenue recognition under ASC 606 and financial close processes.
Experience in a healthcare environment, such as owned clinics, ambulatory care, ancillary services, or comparable provider-side operations.
Ownership of SOX 404 internal controls in a public company setting, including design, documentation, testing, and remediation.
A track record of leading close improvement initiatives and building standardized accounting processes across multiple entities.
Ability to develop teams, communicate with executives, and drive cross-functional alignment.
Ownership of intercompany and intersegment accounting in a multi-entity group, including elimination processes and supporting intercompany pricing.

Responsibilities

Own the Care Delivery segment's accounting function, including the general ledger, chart of accounts, monthly close, balance sheet substantiation, and period-end reporting to the CAO and CFO.
Oversee revenue recognition for owned clinic and ancillary operations, including fee-for-service billing, professional and facility revenue, and contractual adjustments in compliance with ASC 606. Cover fee-for-service revenue net of contractual allowances and implicit price concessions, capitation and performance-based incentives earned within Care Delivery, and other revenue including the Hospital Quality Assurance Fee program. Own estimates underlying net revenue and test them against actual cash collections each period.
Own intercompany and intersegment accounting for transactions between Care Delivery entities and the Care Partners and Care Enablement segments, including charge-setting basis, recording in both directions, and elimination on consolidation.
Own hospital accounting for Foothill Regional Medical Center, including patient accounts receivable and allowance estimates across Medicare, Medi-Cal, managed care, and self-pay populations; supply and pharmacy inventory; capital projects and fixed assets; and provider fee program activity, including the Hospital Quality Assurance Fee and related payable.
Support segment consolidation conclusions, including variable interest and primary beneficiary assessments for clinics and ancillary providers and the distinct treatment of the wholly owned hospital. Work with Technical Accounting to maintain documentation as entities are acquired or restructured.
Support goodwill and long-lived asset impairment testing for reporting units in the segment, including monitoring triggering events and preparing financial inputs for the annual test.
Own lease portfolio accounting for clinic and facility sites under ASC 842, including new sites, renewals, and exits.
Lead and develop the Care Delivery accounting team, assign ownership by entity and process, build cross-coverage, and create an internal talent pipeline.
Design and maintain the segment's internal control environment, document processes, own SOX 404 controls, and ensure timely remediation of deficiencies. Bring acquired entities, including the hospital, into the company's internal control assessment and support improvements to internal control processes, particularly completeness and accuracy of acquired working capital in the segment.
Drive close acceleration and standardization across Care Delivery entities by reducing cycle time, increasing first-pass quality, and eliminating recurring out-of-period adjustments.
Lead accounting integration of acquired clinics and ancillary service lines by onboarding entities onto Astrana's chart of accounts, close calendar, accounting policies, and control framework.
Partner with Revenue Cycle to ensure billing, collections, and adjustments are accurately reflected in and reconciled to the general ledger. Cover clinic and hospital revenue cycle and reconcile the patient accounts receivable subledger to the general ledger each period, with aged and explained differences rather than a plug.
Prepare and review segment financial statements, flux and variance analysis, and executive-level commentary for CAO and CFO review each period.
Coordinate the segment's relationships with external auditors, internal audit, and regulatory bodies by managing request lists, owning delivery timelines, and ensuring first-pass acceptance of support.
Identify and drive automation and efficiency opportunities across the segment to reduce manual effort and build scalable, controlled processes for growth.

Desired Qualifications

An active CPA license.
Acute care hospital accounting experience, including hospital net revenue and allowance estimation, patient accounts receivable, and hospital-specific payer and program reporting.
Big Four or national firm audit background with healthcare or public-company clients.
Experience integrating acquired entities onto a common ledger, policy set, and control framework.
Familiarity with California managed-care or clinic regulations and related reporting requirements.
Experience with ERP implementations or system migrations.
A master's degree.
Familiarity with California hospital programs and reporting, including provider fee or quality assurance fee programs and Medicare and Medi-Cal cost reporting.
Experience supporting variable interest entity consolidation conclusions in a provider organization.

Astrana Health is seeking a Director of Accounting to lead the financial reporting and accounting operations for its Care Delivery segment — our primary and specialty care clinics, post-acute and inpatient services, ancillary providers including urgent care centers, outpatient imaging, ambulatory surgery centers, laboratories and a specialty pharmacy, and Foothill Regional Medical Center, our wholly owned acute care hospital. This is a senior leadership role responsible for the integrity of the segment's general ledger, close process, internal controls, and financial reporting in a fast-growing, publicly traded healthcare company.

Roughly half of the segment’s revenue is earned from other Astrana segments rather than from third parties, so intercompany accounting and elimination are central rather than peripheral. The hospital is its own goodwill reporting unit and joined the company through the Prospect acquisition in July 2025, which means its integration, and its entry into the company’s internal control assessment are all live work. This role is the accounting owner of all of it.

You will report directly to the SVP - Accounting and serve as the primary accounting leader for the Care Delivery segment, partnering closely with the CFO, FP&A, Revenue Cycle, operations leadership, and external auditors. This role requires someone who can operate at a strategic level while staying close enough to the work to identify risk, build scalable process, and develop a high-performing accounting team. You will also work directly with Technical Accounting on consolidation and valuation questions, with the Care Partners and Care Enablement accounting teams on intercompany arrangements, and with Internal Audit on control design.

Own the end-to-end accounting function for the Care Delivery segment — general ledger, chart of accounts, monthly close, balance sheet substantiation, and period-end reporting delivered to the CAO and CFO.
Oversee revenue recognition for owned clinic and ancillary operations, including fee-for-service billing, professional and facility revenue, and contractual adjustments in compliance with ASC 606. Cover the full revenue population of the segment: fee-for-service reported net of contractual allowances and implicit price concessions, capitation and performance-based incentives earned within Care Delivery, and other revenue including the Hospital Quality Assurance Fee program. Own the estimates behind the net revenue position and test them against actual cash collections each period.
Own intercompany and intersegment accounting for the segment — the arrangements under which Care Delivery entities transact with the Care Partners and Care Enablement segments, the basis on which those charges are set, their recording in both directions, and their complete elimination on consolidation. Intersegment activity is close to half of this segment’s revenue.
Own hospital accounting for Foothill Regional Medical Center: patient accounts receivable and the allowance estimates across Medicare, Medi-Cal, managed care and self-pay populations; supply and pharmacy inventory; capital projects and fixed assets; and provider fee program activity including the Hospital Quality Assurance Fee and its related payable.
Support the consolidation conclusions across the segment — variable interest and primary beneficiary assessments for the clinics and ancillary providers, and the distinct treatment of the wholly owned hospital — working with Technical Accounting to keep the documentation current as entities are acquired or restructured.
Support goodwill and long-lived asset impairment testing at the reporting units within the segment, including monitoring for triggering events and preparing the financial inputs to the annual test.
Own the segment’s lease portfolio accounting for clinic and facility sites under ASC 842, including new sites, renewals and exits.
Lead and develop the Care Delivery accounting team, setting clear ownership by entity and process, building cross-coverage, and creating a pipeline of internal talent.
Design and maintain a strong internal control environment — documenting processes, owning SOX 404 controls for the segment, and ensuring timely remediation of any deficiencies. Bring acquired entities, including the hospital, into the company’s internal control assessment, and support improvement in the company’s internal control process — in particular the completeness and accuracy of acquired working capital in this segment.
Drive close acceleration and standardization across all Care Delivery entities, reducing cycle time, increasing first-pass quality, and eliminating recurring out-of-period adjustments.
Lead the accounting integration of newly acquired clinics and ancillary service lines — onboarding entities onto Astrana's chart of accounts, close calendar, accounting policies, and control framework.
Partner with Revenue Cycle to ensure that billing, collections, and adjustments are accurately reflected in the general ledger and reconcile end-to-end. Cover both clinic and hospital revenue cycle, and reconcile the patient accounts receivable subledger to the general ledger every period with aged, explained differences rather than a plug.
Prepare and review segment financial statements, flux and variance analysis, and executive-level commentary for CAO and CFO review each period.
Coordinate the segment's relationship with external auditors, internal audit, and regulatory bodies — managing request lists, owning delivery timelines, and ensuring first-pass acceptance of support.
Identify and drive automation and efficiency opportunities across the segment, reducing manual effort and building scalable, controlled processes to support continued growth.

Bachelor's degree in Accounting, Finance, or a related field; CPA. An active license is preferred but not required.
10+ years of progressive accounting experience, including demonstrated leadership of multi-entity or multi-site accounting operations
Deep knowledge of US GAAP, including revenue recognition (ASC 606) and financial close processes
Experience in a healthcare environment — owned clinics, ambulatory care, ancillary services, or comparable provider-side operations Acute care hospital accounting experience is preferred — hospital net revenue and allowance estimation, patient accounts receivable, and hospital-specific payer and program reporting.
Proven ownership of SOX 404 internal controls in a public company setting — design, documentation, testing, and remediation
Track record of leading close improvement initiatives and building standardized accounting processes across multiple entities
Strong leadership presence with the ability to develop teams, communicate clearly with executives, and drive cross-functional alignment
Demonstrated ownership of intercompany and intersegment accounting in a multi-entity group, including the elimination process and the support behind intercompany pricing.

Preferred

Big Four or national firm audit background with healthcare or public-company clients
Experience integrating acquired entities onto a common ledger, policy set, and control framework
Familiarity with California managed-care or clinic regulations and related reporting requirements
Experience with ERP implementations or system migrations; Master's degree a plus
Familiarity with California hospital programs and reporting, including provider fee or quality assurance fee programs and Medicare and Medi-Cal cost reporting.
Experience supporting variable interest entity consolidation conclusions in a provider organization.

About the Company

Astrana Health

Technology-enabled platform delivering value-based care

Astrana Health runs a physician-focused, technology-enabled care platform that supports providers in delivering proactive, preventive, value-based care. Its end-to-end system coordinates care across affiliated networks, a management services organization, and primary, specialty, and ancillary clinics to help more than 20,000 providers and over 1.6 million Americans in value-based arrangements. How it works: the proprietary platform connects clinicians, patients, and care settings, enabling proactive care planning, care coordination, and efficient delivery of services in primary and specialty care. The company differentiates itself by combining a large provider network, an MSO, and clinics with a single tech platform to scale value-based care and improve patient experiences and outcomes rather than relying on fragmented, fee-for-service models. Its goal is to create a healthcare system that delivers better care, better experiences, and better outcomes for all.

Company size: 501-1,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Alhambra, CA
Founded: Not listed

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