Sr. Accounting Manager, Provider Compensation

Integrated Dermatology is a leading national dermatology practice that acquires and partners with dermatology practices across the United States. Our environment is built on collaboration, accountability, and operational excellence.

The Senior Manager – Provider Compensation leads the provider compensation accounting function for a large, multi-state physician practice network and manages the team responsible for the accurate, timely calculation, accounting, and reporting of compensation for more than 200 physicians and advanced practice providers. The role owns end-to-end governance of complex compensation arrangements, including percentage-of-collections models, profit and loss sharing, productivity and growth incentives, guarantees and draws, custom contractual calculations, and related intercompany transactions.

This leader is the primary finance subject matter expert for translating provider contractual terms into clear, auditable mathematical calculations. The Senior Manager proactively partners with Legal, Operations, Human Resources, Payroll, Revenue Cycle, and Finance during the contracting and amendment process to identify ambiguity, operational complexity, accounting implications, and data requirements before agreements are finalized. The role also owns the master provider compensation matrix and ensures every arrangement is current, complete, documented, and consistently reflected in calculation models, accounting records, and payment processes.

The ideal candidate combines strong accounting and analytical capabilities with leadership, contract interpretation, process discipline, and the ability to communicate complex compensation mechanics clearly to providers and senior leadership.

Team Leadership & Functional Ownership

•  Manage, develop, and provide technical oversight to the provider compensation team responsible for more than 200 providers across multiple legal entities and compensation structures.

•  Own the monthly provider compensation close process, including work allocation, review standards, deadlines, issue escalation, and final approval of calculations and accounting entries.

•  Establish procedures, review controls, documentation standards, and cross-training to ensure continuity, accuracy, and scalability.

•  Serve as the senior escalation point for complex provider compensation questions and disputes.

Provider Compensation Governance & Master Matrix

•  Own and maintain the master provider compensation matrix as the authoritative source for all arrangements, including legal entity, effective dates, methodology, rates/percentages, thresholds, guarantees, draws, profit/loss sharing, expense allocations, supervisory fees, incentives, true-up provisions, payment timing, and other contractual terms.

•  Ensure new agreements, amendments, renewals, terminations, and provider changes are reflected timely and accurately in the matrix and supporting calculation models.

•  Maintain supporting documentation and version control so each calculation can be traced directly to the applicable contractual provision.

•  Perform periodic audits of the master matrix against executed agreements, payroll records, accounting schedules, and provider rosters.

Contract Review & Translation to Calculation

•  Proactively participate in provider contracting and amendments before execution to ensure compensation terms can be operationalized and calculated accurately.

•  Review proposed contractual language and translate economic terms into clear mathematical formulas, calculation examples, data requirements, accounting treatment, and payment schedules.

•  Identify ambiguous, conflicting, incomplete, or administratively burdensome provisions and work with Legal, Operations, and leadership to resolve them before execution.

•  Assess downstream impacts on payroll, general ledger accounting, intercompany allocations, provider reporting, and system requirements.

•  Document approved calculation methodologies and ensure the final model is consistent with the executed agreement.

•  Review model and calculations with the provider prior to first pay check to ensure mutual understanding and alignment on timing of deliverables, method of receiving the information, and payment.

Complex Provider Compensation Accounting

•  Oversee and review monthly calculations across models including percentage of collections, productivity-based compensation, profit and loss sharing, allocated profit pools, growth incentives, guarantees, draws, supervisory fees, and other custom arrangements.

•  Oversee complex profit and loss calculations requiring revenue attribution, direct expenses, shared overhead allocations, provider-specific adjustments, and contractual exclusions or add-backs.

•  Ensure accruals, true-ups, liabilities, and related journal entries are recorded accurately and timely in accordance with U.S. GAAP and company policy.

•  Own accounting for arrangements spanning multiple entities, including identification, calculation, reconciliation, and documentation of intercompany charges, receivables/payables, and allocations.

•  Reconcile compensation calculations and payments to collections, payroll, accounts payable, provider statements, and the general ledger.

Financial Analysis, Reporting & Provider Support

•  Review monthly compensation reporting packages, provider statements, variance analyses, and management reporting for accuracy and completeness.

•  Analyze productivity, collections, profitability, compensation trends, and material variances; investigate and resolve anomalies.

•  Develop dashboards, schedules, and KPIs providing visibility into compensation expense, accrual accuracy, true-ups, and outstanding issues.

•  Explain complex calculations, variances, and adjustments clearly to providers, practice administrators, operational leaders, and executives.

Controls, Audit & Process Improvement

•  Design and maintain a strong control environment including preparer/reviewer controls, contract-to-calculation validation, change controls, reconciliations, and documented approvals.

•  Support internal and external audits with complete, organized, and auditable compensation documentation.

•  Identify opportunities to standardize and automate calculations, reporting, provider onboarding, and change-management workflows while preserving individual contract requirements.

•  Lead compensation workstreams for acquisitions, provider onboarding, system implementations, and transitions to new compensation models.

•  Partner with Finance and executive leadership to identify recurring contractual complexity and recommend more scalable structures and processes.

•  Bachelor’s degree in Accounting, Finance, or related field required; CPA or advanced degree preferred.

•  7+ years of progressive accounting, financial analysis, or provider compensation experience, including team leadership or ownership of a complex functional process.

•  Healthcare accounting experience strongly preferred; physician practice management or multi-site provider compensation experience required.

•  Demonstrated experience interpreting complex contracts and converting contractual terms into mathematical calculations, accounting treatments, and repeatable operational processes.

•  Experience with complex physician compensation models, including percentage of collections, profit/loss sharing, productivity incentives, guarantees/draws, and custom calculations.

•  Experience with multi-entity accounting and intercompany transactions, allocations, reconciliations, and eliminations.

•  Strong understanding of U.S. GAAP, accrual accounting, reconciliations, and internal controls.

•  Advanced Microsoft Excel skills; experience with ERP, payroll, reporting, and data systems. Exceptional analytical, problem-solving, organizational, documentation, leadership, and communication skills.

Education:

• Bachelor’s Degree in Accounting, Finance, Business, or related field required
• CPA or advanced degree preferred

Job Type:

• Full-time
• #LI-SF1

Integrated Dermatology and it's entities provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.