Astrana Health

Director

• Leads contract negotiations, as assigned, including risk-based agreements, fee-for-service negotiations, pay for performance programs, and ACO agreements with health plans
• Manages contractual relationships with payers and internal stakeholders
• Reviews health plan contract language and is familiar with payor, medical group/IPA, and hospital/ancillary contract language and reimbursement mechanisms
• Circulates draft contract terms/language to various internal departments for review & approval
• Applies knowledge of healthcare delivery system, IPA operations, managed care, healthcare laws in assisting with the development of contracting strategies
• Answers and/or resolves inquiries from health plans or internal departments in a timely manner
• Establishes good working relationships with health plan representatives and internal teams
• Develops tools (e.g., dashboards, grids, tables, summaries) to provide organizational leadership key contract data
• Utilizes applicable financial tools and reports to evaluate performance of current contracts
• Interacts and consults with Network Pricing team to evaluate different financial arrangements and recommend applicable payment methodologies
• Ensures compliance and consistent contracting across the enterprise.
• Manages various ad-hoc project requests with short turnaround time.
• Performs other duties as assigned.

Senior Director – Payer Contracting

Full-stack Engineer

• Design, test, deploy, improve, and maintain software that will be used internally at Astrana Health, and externally by physicians and patients
• Work cross-functionally with an agile team including Product, UX/Design, Engineers, and QA to execute mission-critical projects
• Suggest and drive improvement on all parts of the stack and internal development processes
• Manage project requirements, priorities, and deliverable timelines effectively
• Help mentor, coach, and develop junior members of our development team
• Technology Stack: Python, React, Javascript, SQL

Senior Software Engineer

Engineer

• You will embed directly within clinical, operations, and market teams and build systems that change how care is delivered and how the business performs.
• In a given month, you might:
• - Build an AI-driven tool to help care teams prioritize high-risk patients
• - Automate a workflow that is currently manual and impacting revenue or cost
• - Deploy an LLM-based system on top of messy clinical or claims data
• - Create internal tools that providers and operators rely on every day
• This role is about shipping real systems that work in the real world - not prototypes or isolated experiments.

Forward Deployed Engineer

Bilingual

• Conduct outreach to members with specified clinical gaps to help coordinate care and gap closure activities
• Schedule appointments for patients with the internal team and/or external provider offices
• Manage work through multiple portals required to access all relevant patient data
• Conduct outreach to provider offices in efforts to help patients schedule appointments, relay relevant health information, or obtain medical records
• Manage sms and email queues as assigned for incoming and outgoing patient communication
• Able to communicate with members in a language with or without the use of translation services
• Manage basic office functions such as faxing, voicemail, and mail
• Able to accurately enter patient data into relevant platforms and document outcomes in a clear and concise manner
• Able to educate patients on basic healthcare terminology and topics
• Pre-visit prep: assist with confirmation calls, rescheduling, and chart prep
• Post-visit work: assist in closing out any visit orders, such as referrals, faxing of notes, sending lab referrals, etc
• Assist patients in completing health questionnaires and documenting responses within EMR and/or designated platform.
• Maintain all patient data in compliance with the organization’s PHI practices and following Health Insurance Portability and Accountability Act (HIPAA) standards
• Other duties as assigned

Health Navigator, Bilingual Spanish

Coach

• Serve as a strategic advisor to provider practices, assessing clinical, operational, and financial performance and identifying opportunities for improvement
• Exercise independent judgment in prioritizing practice engagements and determining the most effective intervention strategies based on performance data and business impact
• Develop and lead execution of customized transformation plans to improve quality metrics, operational workflows, and financial outcomes
• Lead the design and implementation of workflow redesign initiatives, including EHR optimization, clinical documentation, and billing practices
• Diagnose root causes of quality and financial underperformance and develop targeted, data-driven solutions
• Provide guidance to providers and care teams to support adoption of optimized workflows and sustainable operational improvements
• Analyze and interpret complex performance data, including HEDIS, pay-for-performance metrics, and medical cost trends, to inform strategic recommendations
• Translate data insights into actionable performance improvement strategies tailored to individual practices and market needs
• Monitor progress against established goals and adjust strategies as needed to ensure performance targets are achieved
• Partner with internal stakeholders across Market Operations, Quality, and Population Health to ensure alignment on performance improvement initiatives
• Influence provider and practice-level decision-making through data-driven insights, education, and consultative engagement
• Serve as a key liaison between provider practices and organizational leadership to escalate risks, share insights, and drive alignment
• Identify trends and systemic opportunities across practices to inform broader market-level or enterprise performance strategies
• Contribute to the development of best practices, tools, and frameworks that enhance practice transformation efforts across the network
• Support special projects and strategic initiatives aligned with value-based care performance goals

Practice Transformation Coach

Supervisor

• Develop data structure and software applications
• Improve software platforms and systems to support business needs
• Design, test, deploy, improve, and maintain software used internally and externally
• Apply expertise on emerging or existing massive data to create and scale insights
• Develop large-scale models to enhance company efficiency
• Troubleshoot, debug, and upgrade distributed systems
• Produce specifications and determine operational feasibility
• Collaborate with functional teams to integrate software applications
• Manage project requirements and deliverable timelines
• Supervise EDI Analyst I & II
• Telecommuting permitted from within the U.S.

Supervisor – Electronic Data Interchange

Medical Billing and Coding

• Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company.
• Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC).
• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines.
• Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
• Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing.
• Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
• Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
• Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
• Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
• May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I.
• Other duties as assigned.

Risk Adjustment Coding Specialist I

Customer Support

• Conduct on-site and virtual visits with healthcare providers and office staff to support AWV performance, documentation, and workflow optimization.
• Manage a caseload of physician practices, building trust and providing ongoing education and support.
• Collect required medical records and documentation to address AWV gaps and incomplete submissions.
• Document all visits, observations, and identified needs for practice improvement.
• Prepare and maintain various performance and operational reports, including monthly progress and summary reports for assigned offices, AWV incentive tracking (as required), PAF forms upon request, incomplete or rejected documentation reports, and vendor reports for coordinator distribution.
• Create AWV calling lists for QCC outreach (priority lists, embedded clinic days, special projects, etc.).
• Coordinate and collaborate with internal departments to support effective workflow and communication for the embedded NP program.
• Partner with the NM team to support provider onboarding and clinic day preparation.
• Coordinate vendor calling efforts and NP availability.
• Collaborate with offices, NMs, and Regional Managers to resolve escalations.
• Maintain and save progress reports, ensuring accuracy and accessibility.
• Attend all meetings and calls related to the NP program.
• Prepare and submit check requests to finance.
• Order, track, and process incentive gift cards.
• Prepare forms and distribute physical or e gift cards as needed.
• Support provider offices in improving year-over-year AWV submission rates, targeting 80% for senior lines of business.
• Utilize all available tools and resources to support Performance Programs initiatives.
• Assist practices in identifying operational barriers that hinder encounter data capture.
• Conduct practice assessments and use findings to guide workflow redesign and create SMART goals.
• Recommend opportunities for improvement and assist with office workflow redesign to support efficiency and documentation accuracy.

Practice Support Specialist

Manager

• Conduct comprehensive health assessments, including medical, behavioral, and social determinants of health (SDOH)
• Develop, implement, and evaluate individualized care plans based on member needs, goals, and risk level
• Coordinate care across multiple settings, including inpatient, outpatient, and community-based services
• Facilitate transitions of care, including hospital discharge planning and post-discharge follow-up
• Utilize clinical expertise to identify gaps in care, potential risks, and opportunities for early intervention
• Monitor member progress and adjust care plans accordingly
• Provide education to members and caregivers regarding disease management, medications, and treatment plans
• Apply evidence-based guidelines and best practices in care management
• Support appropriate utilization of healthcare services to ensure cost-effective care delivery
• Collaborate with utilization management teams to reduce avoidable hospitalizations and emergency department visits. Identify high-risk members and implement strategies to improve outcomes and reduce healthcare costs
• Partner with physicians, specialists, behavioral health providers, and community agencies to coordinate care
• Serve as a liaison between members, providers, and health plan resources
• Participate in interdisciplinary team meetings and case conferences
• Maintain effective communication to ensure continuity of care
• Ensure timely and accurate documentation in accordance with regulatory, CMS, and organizational requirements
• Support quality improvement initiatives, including HEDIS, STAR ratings, and other performance measures
• Maintain compliance with accreditation standards and internal policies
• Conduct outreach to engage members in care management programs
• Promote self-management and adherence to treatment plans. Address barriers to care, including social, economic, and cultural factors

Care Manager, RN

Financial Planning and Analysis

• Lead annual budgeting, monthly forecasting, and multi-year financial planning, including development of financial models for strategic and operational decision-making.
• Perform variance analysis and partner with business leaders to assess performance, identify drivers, and support operational planning.
• Oversee monthly financial reporting, dashboards, and executive presentations communicating business performance.
• Analyze results across business segments to identify trends, risks, and opportunities, delivering actionable insights to senior leadership.
• Lead ad hoc financial analyses to support strategic initiatives, operational improvements, and investment decisions.
• Develop advanced financial models and business cases, including ROI, sensitivity, scenario analysis, and time studies, in collaboration with cross-functional teams.
• Advance FP&A analytical capabilities through enhanced financial modeling, analytics, and reporting tools.
• Drive process improvements, automation, and data accuracy in partnership with data and technology teams.
• Provide leadership, mentorship, and oversight to FP&A team members while fostering analytical rigor and continuous improvement.
• Support professional development through coaching, project ownership, and exposure to strategic financial initiatives.

Financial Planning and Analysis Manager

Accounting Manager

• Direct management and development of a team of accountants.
• Review IPA/RKK related journal entries: capitation, claims, risk pools, AR/AP, and accrual related entries.
• Review, maintain and reconcile the general ledger on a monthly basis; prepare monthly balance sheet analyses for multiple assigned entities.
• Ensure accurate and timely month-end and year-end close.
• Work closely with the reporting team to provide accurate and timely information for SEC filing and to the external auditors
• Ensure financial records are maintained in compliance with U.S. GAAP
• Manage internal and external ad-hoc requests
• Work with external auditors to provide support as requested

Manager – Accounting, IPA

Operations

• Lead high-impact, cross-functional initiatives focused on transforming core operations, modernizing systems, and driving scalable, enterprise-wide solutions aligned with strategic priorities
• Partner with senior leadership to operationalize key initiatives, ensuring alignment across teams and measurable outcomes
• Identify opportunities to streamline workflows and improve performance through process redesign, automation, and AI-enabled solutions in collaboration with data and engineering teams
• Serve as a central point of integration across business units, connecting operations, analytics, technology, and strategy teams to deliver cohesive outcomes
• Leverage data insights to inform initiative design, monitor performance, and continuously refine solutions
• Play a key role in enterprise integration efforts, including system transitions and operational transformations
• Collaborate with strategic vendors and partners to implement solutions aligned with Astrana Health’s long-term vision
• Thrive in a fast-paced environment, managing multiple priorities while maintaining strong attention to detail
• Communicate effectively with stakeholders at all levels, including executive leadership

Senior Manager, Strategic Operations

• Comply with Case Management Department’s policies and procedures
• 95 - 100% compliance with Utilization Management health plan delegation standards for Case Management
• Utilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge plan
• Collaborating with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission
• Responsible for coordinating the required initial and concurrent reviews based on the review of medical records received and daily accurate reporting of all inpatient admissions to Medical Director and Manager and/ or Supervisor of Case Management Department
• Review of medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate Guidelines
• Assess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission
• Attends/coordinates Case Management meetings on and off-site as necessary
• Conduct Hospital On-Site visits with members to ensure transition of care from hospital to lower level of care
• Interacts with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements
• Attend to provider and interdepartmental calls in accordance with exceptional customer service
• Maintain good relationships with health plans, hospitals and medical directors.
• Resolve problems that arise with any IPA medical directors
• Report to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the day
• Other duties as assigned

Case Manager, LVN/RN – On-Field

• Develop and execute multi-year clinic growth strategy across existing and new markets
• Identify expansion opportunities (de novo sites, service line growth, partnerships, acquisitions)
• Build financial models and investment cases to support capital allocation decisions
• Conduct market, competitive, and payer landscape analysis
• Own clinic-level KPIs including volume, revenue, margin, quality, and access
• Establish standardized dashboards and reporting to drive accountability
• Improve provider productivity, patient throughput, and cost efficiency
• Lead performance turnaround initiatives where needed
• Lead high-impact, cross-functional initiatives across clinical, finance, people, and technology teams
• Drive disciplined project management and risk mitigation
• Translate strategy into clear implementation roadmaps with defined outcomes
• Build and develop a high-performing strategy and operations team
• Foster a culture of accountability, ownership, and continuous improvement

Director – Clinic Growth and Operations

• Contribute to the design and execution of Astrana Health’s enterprise analytics roadmap aligned with growth and value-based care objectives.
• Lead the development of scalable analytics solutions and BI dashboards using tools such as Databricks and Power BI.
• Implement and maintain strong data governance and development practices to ensure data accuracy, compliance, and trust.
• Build customized reports and dashboards tailored to functional and executive stakeholders.
• Partner with business units like Risk Adjustment and Quality to identify analytical opportunities, translate business needs into technical solutions, and deliver insights with measurable impact.
• Support standardization and optimization of reporting/analytics capabilities across teams.
• Mentor analysts and engineers, fostering technical excellence and a collaborative team environment.
• Manage project timelines, deliverables, and stakeholder expectations while communicating technical concepts to non-technical audiences.
• Promote best practices in analytics, data engineering, and BI development.
• Lead and mentor a team of analytics professionals supporting HEDIS quality measurement and Risk Adjustment Factor (RAF) analytics.
• Own end-to-end execution of key deliverables: HEDIS measure calculation, gap-to-goal reporting, compliance rate optimization, and RAF accuracy analytics across multiple lines of business.
• Partner with business stakeholders (Clinical Operations, Quality Improvement, Finance) to translate requirements into scalable analytic solutions and drive actionable insights.
• Establish QA protocols and ensure data integrity for all reporting deliverables.
• Drive improvements to Star Ratings performance and risk score accuracy through advanced analytics and process optimization.
• Partner with Data Engineering and IT to enhance data infrastructure, implement new measures, and resolve source data quality issues.
• Conduct performance reviews and set development goals, to build team strength.