Director - Accounting (Care Delivery)

What You'll Do

• 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.

Qualifications

• 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.

• 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.

Environmental Job Requirements and Working Conditions

• This position is in office with the option to be hybrid. The office is located at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
• The national target pay range for this role is $160,000 to $200,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.