Senior Manager, Technical Revenue Accounting

Position Type: Full Time, exempt employee

Salary Range: $140,000 -$180,000 annually, DOE; may be eligible for bonus. Compensation will be based on the candidate’s experience, qualifications, and geographic location.

Location: This position based onsite at the Service Center in San Juan Capistrano, CA.

About the Company
Ensign Services, Inc. (“ESI”) is a subsidiary of The Ensign Group, Inc., which is a national leader in the operation of skilled nursing, senior living, rehabilitation, home health, hospice, and other healthcare services. ESI is known as the “Service Center” and provides the facilities and leaders it serves with “back-office” support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting.

We seek individuals who thrive in a dynamic environment, embrace continuous learning, and are passionate about making a meaningful impact. We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership (“CAPLICO”) seriously. We want an individual in this role who will demonstrate these values through actions and words.

About the Opportunity

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.

Job Duties and Responsibilities include, but are not limited to:

Technical Revenue Accounting

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.

Healthcare Reimbursement & Revenue Analytics

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.

Financial Close & Reporting

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.

Audit, Compliance & Controls

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.

Systems & Process Improvement

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.
Leadership & Cross-Functional Collaboration
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.

Requirements:

Bachelor's degree in Accounting, Finance, Healthcare Administration, or related field required. CPA preferred.
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. 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.
Understanding of internal controls, audit support, SOX compliance, and documentation standards.
% of travel may be required occasionally.

Physical Requirements:

Standard Office Environment

More than 50% of the time:

Sit, stand, walk.
Repetitive movement of hands, arms and legs.
See, speak and hear to be able to communicate.

Less than 50% of the time:

Stoop, kneel or crawl.
Climb and balance.
Carry and lift 10-20 lbs.

Additional Information

Any offer of employment may be contingent upon the successful completion of job-related post-offer requirements, which may include background checks, reference checks, and/or other screenings or examinations as permitted by applicable law.

What We Offer
We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. Additionally, enjoy access to our fully equipped onsite gym (San Juan Capistrano office location). We also believe in supporting our employee’s professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com

This company is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.

Job ID: 1712

Senior Manager, Technical Revenue Accounting

About the job