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Capitation Analyst I in Orange at Prospect Medical Systems

Date Posted: 8/9/2018

Job Snapshot

  • Employee Type:
  • Location:
    600 City Parkway West
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
  • Job ID:

Job Description

Capitation Analyst I

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

Capitation Analyst I Communicate and disseminate, guidelines or documentation relating to Capitation payments for PCPs and Specialists. Creates reports and evaluates all potential recovery. Plan and set goals, in dynamic environment, for department goals. Develop self, and maintain knowledge of managed care industry at all times.

Job Responsibilities/Duties

  • Requires experience and extensive knowledge in each of the following areas: PCP Payments – Candidate needs to understand how PCP capitation payments are made. Specialist Capitation Payments – Needs to understand how payments are made and calculated
  • Compiles capitation payments data for analysis and trending purposes. Identifies key capitation data shifts and presents findings.
  • Responsible for the monthly maintenance and data integrity of the capitation. On-going testing, validation, monitoring and financial reporting of the capitation module with continued efforts relating to processes improvement.
  • Creates monthly, quarterly, and annual PCP and Specialist payments for internal review.  Develops new, routine and ad hoc reports for Providers and Finance Department for PCP and Specialist Capitation payments.
  • Actively participate in supporting internal departments with analysis and reports.
  • Other duties as assigned.


Minimum Education: Bachelor's degree or equivalent education and experience in Finance or related field preferred.  

Minimum Experience: Experience with capitation processing in an HMO managed services organization preferred. Some financial analysis experience in the health care environment preferred.

Req. Certification/Licensure: None. 

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

How to Apply

To apply for this role, or search our other openings, please visit and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

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