Senior Manager, Technical Revenue Accounting

Ensign Services•Irvine, CA

5h•$140,000 - $180,000•Onsite

About The Position

The Senior Manager, Technical Revenue Accounting is responsible for leading complex revenue programs, reimbursement arrangements, and technical revenue accounting initiatives that impact the Company's financial reporting. This role serves as a cross-functional bridge between Revenue Technical Accounting, Reimbursement, Revenue Cycle, Operations, Finance, IT, and senior leadership to support accurate revenue recognition, strong internal controls, and scalable revenue processes. This position is designed for a strategic individual contributor or lead-level professional who can evaluate complex reimbursement models, document accounting conclusions, support close and audit activities, and drive process improvement through data analytics, automation, and cross-functional partnership.

Requirements

Bachelor's degree in Accounting, Finance, Healthcare Administration, or related field required.
10+ years of progressive accounting, finance, reimbursement, revenue recognition, or revenue management experience; healthcare industry experience strongly preferred.
Strong understanding of U.S. GAAP, ASC 606, revenue recognition, net patient revenue accounting, reserves, estimates, and accounting documentation.
Experience with Medicare, Medicaid, Managed Care, reimbursement methodologies, value-based or quality programs, and complex patient service revenue models preferred.
Advanced Excel skills required.
Understanding of internal controls, audit support, SOX compliance, and documentation standards.

Nice To Haves

CPA preferred.
Experience with ERP and reporting platforms such as OneStream, Power BI, Workday, or similar systems preferred.
Support additional tasks and special ad hoc projects as assigned.
% of travel may be required occasionally.

Responsibilities

Lead revenue-related programs and initiatives impacting patient service revenue and reimbursement.
Serve as a subject matter expert for complex revenue arrangements, reimbursement structures, and program implementation matters.
Evaluate new reimbursement programs, contractual arrangements, payor initiatives, and operational changes for financial statement impacts.
Coordinate implementation of new revenue programs across Accounting, Reimbursement, Revenue Cycle, Operations, Finance, and IT.
Establish governance, documentation standards, timelines, and accountability for revenue-related initiatives.
Interpret and apply revenue recognition guidance under ASC 606 and other applicable U.S. GAAP standards.
Prepare, review, and maintain technical accounting memorandums supporting revenue conclusions and key estimates.
Analyze and document accounting treatment for unique reimbursement programs, managed care contracts, value-based payment arrangements, and other complex revenue matters.
Communicate accounting impact to cross functional teams and field operational partners.
Analyze Medicare, Medicaid, Managed Care, and other reimbursement arrangements, including state quality or supplemental payment programs where applicable.
Monitor state and federal reimbursement updates and assess related accounting, reporting, and operational impacts.
Review net patient revenue estimates, contractual allowances, reserves, settlement accruals, and related assumptions.
Perform revenue trend analysis and identify key drivers impacting financial performance.
Develop reporting, dashboards, and KPIs to improve visibility into revenue trends, program performance, and financial risks.
Support monthly, quarterly, and annual financial reporting requirements related to revenue recognition and net patient revenue.
Review revenue journal entries, reconciliations, variance analyses, and supporting schedules.
Review revenue fluctuations and prepare executive-level explanations of significant trends, drivers, and risks.
Partner with M&A team and operational leaders to support pro forma and revenue projections.
Assist with financial statement disclosures and other external reporting support related to revenue.
Serve as a key contact for external audit requests related to revenue, reimbursement programs, reserves, and accounting conclusions.
Ensure documentation supports key revenue estimates, assumptions, judgments, and accounting positions.
Maintain and enhance internal controls over revenue, including SOX-related controls where applicable.
Support internal audits, compliance reviews, and regulatory examinations.
Recommend enhancements to the revenue control environment, monitoring procedures, and documentation standards.
Identify opportunities to streamline, standardize, and automate revenue accounting and reporting processes.
Partner with IT and business stakeholders to implement reporting tools, system integrations, and data enhancements.
Support revenue-related ERP, billing, reimbursement, EMR, and reporting system initiatives.
Develop templates, analytical tools, and repeatable processes to improve reporting accuracy and efficiency.
Serve as a trusted advisor to Accounting, Finance, Reimbursement, Revenue Cycle, Operations, and IT teams.
Lead cross-functional project teams for strategic revenue initiatives and process improvement efforts.
Train and mentor accounting and finance professionals on technical revenue matters, reimbursement concepts, and documentation expectations.
Present findings, risks, and recommendations to management and senior leadership in a clear and actionable manner.