Position SummaryThe Controller is a hands-on financial leader responsible for the full accounting function of a mission-driven nonprofit mental health care organization. Reporting to the CFO, this role leads day-to-day accounting operations, safeguards financial integrity, maintains an efficient close and reporting cycle, strengthens internal controls, and ensures compliance with generally accepted accounting principles, nonprofit requirements, grants and contracts, and applicable health care regulations. The Controller partners with clinical, revenue cycle, development, human resources, and executive leaders to produce reliable information that supports sound decisions and sustainable delivery of care.
Essential Duties and ResponsibilitiesAccounting Operations and Close- Lead the full accounting cycle, including general ledger, accounts payable, accounts receivable, cash receipts, fixed assets, leases, prepaid expenses, accruals, payroll accounting, allocations, and intercompany activity.
- Own the monthly, quarterly, and annual close; establish schedules, review reconciliations and journal entries, resolve variances, and deliver timely, accurate financial statements.
- Maintain the chart of accounts, accounting policies, closing calendar, supporting schedules, and documentation standards.
- Ensure appropriate accounting for net assets with and without donor restrictions, contributions, grants, contracts, program service revenue, and other funding sources.
Financial Reporting, Analysis, and Budget Support- Prepare clear monthly and annual financial statements, management reports, departmental results, forecasts, cash analyses, and variance explanations.
- Support the annual operating and capital budget process, including templates, assumptions, consolidations, and ongoing budget-to-actual monitoring.
- Develop useful reporting for executive leadership, the Finance Committee, and the Board of Directors.
- Translate complex financial information for nonfinancial leaders and recommend corrective actions when results differ from plan.
Health Care Revenue and Reimbursement- Partner with revenue cycle and clinical operations to reconcile patient service revenue, receivables, contractual adjustments, denials, refunds, unapplied cash, and payer settlements.
- Review accounting estimates and reconciliations associated with Medicaid, Medicare, managed care, commercial insurance, self-pay, and other third-party reimbursement, as applicable.
- Lead preparation of cost reports, rate documentation, payer audits, and other reimbursement-related filings.
Grants, Contracts, and Donor Restrictions- Oversee grant and contract accounting, including award setup, restricted-fund tracking, allowable-cost review, indirect-cost allocation, invoicing, drawdowns, match requirements, and financial reporting.
- Partner with program and development teams to monitor spending, meet reporting deadlines, and address budget or compliance risks.
- Maintain auditable records for government, foundation, and donor-funded programs.
Audit, Tax, Compliance, and Internal Controls- Coordinate the annual financial statement audit; manage schedules, requests, and issue resolution.
- Prepare or review support for Form 990, state charitable registrations, tax filings, and other required financial reports in coordination with external advisers.
- Design, document, test, and continuously improve internal controls, segregation of duties, approval authorities, fraud prevention measures, and financial policies.
- Maintain audit readiness throughout the year and lead timely remediation of findings.
Systems, Process Improvement, and Data Integrity- Serve as a finance systems owner for the general ledger and connected payroll, expense, billing, banking, purchasing, and reporting platforms.
- Strengthen workflows through automation, standardization, and clear documentation while preserving effective controls.
- Maintain financial data quality across systems and lead issue resolution with information technology, vendors, and operational teams.
Team Leadership and Organizational Partnership- Lead, coach, and develop accounting staff; set clear responsibilities, service standards, cross-training plans, and performance expectations.
- Build productive relationships with operations, clinical services, revenue cycle, grants, development, human resources, and information technology.
- Promote accountability, confidentiality, responsiveness, and continuous improvement within the finance function.
- Serve as the CFO's primary operational accounting partner and provide coverage for critical finance functions when needed.
- Perform other duties and special projects consistent with the role.
Required Qualifications- Bachelor's degree in accounting, finance, or a related field.
- At least seven years of progressively responsible accounting experience, including ownership of the close and financial reporting process and at least three years of supervisory experience.
- Strong knowledge of U.S. GAAP, internal controls, reconciliations, financial statement preparation, and audit support.
- Demonstrated ability to manage detailed transactional work while improving processes and advising senior leaders.
- Advanced spreadsheet skills and experience with modern accounting and reporting systems.
- Excellent judgment, organization, analytical ability, written communication, and interpersonal skills.
- Commitment to confidentiality, ethical stewardship, and the organization's mental health care mission.
Preferred Qualifications- Certified Public Accountant (CPA) or equivalent advanced credential.
- Experience in nonprofit health care, behavioral health, community mental health, or a similarly regulated human services environment.
- Knowledge of nonprofit fund accounting, donor restrictions, government grants, Uniform Guidance, Medicaid or Medicare reimbursement, and Single Audit requirements.
- Experience with Missouri Department of Mental Health Cost Reports.
Leadership Competencies- Mission-centered stewardship: Connects sound financial management to access, quality, and continuity of mental health care.
- Hands-on ownership: Moves comfortably between detailed accounting work and enterprise-level analysis.
- Controls mindset: Anticipates risk, documents processes, and balances compliance with efficient service.
- Collaborative communication: Explains financial matters clearly and builds trust across clinical and administrative teams.
- Continuous improvement: Simplifies work, develops people, and creates scalable, reliable processes.
