Director of Finance - Multi-State Healthcare Enterprise

Location: Southfield, MI
Department: Finance
Employment Type: Full-Time
Reports To: Chief Financial Officer
Role Type: Finance Leadership
Scope: Multi-State Medical Group, MSO, and Affiliated Technology & Service Companies

Position Summary

The Director of Finance is a senior finance leader responsible for overseeing financial operations, accounting, reporting, internal controls, cash management, financial planning, and analytics across a complex, multi-state healthcare enterprise.

This position will oversee financial close and reporting across the medical group, MSO, and affiliated technology and service companies while ensuring the accuracy, integrity, and scalability of financial information and processes.

Working closely with the CFO and executive leadership, the Director will connect financial performance with operational and clinical drivers, identify risks and opportunities, and provide actionable insights that support growth, profitability, and long-term organizational strategy.

The ideal candidate combines the discipline of a Controller with the mindset of an operator, strategic analyst, and technologist. This is a hands-on leadership role for someone who is comfortable moving between detailed accounting, financial analysis, operational problem-solving, and technology-driven process improvement.

What You'll Do

Accounting & Financial Reporting

• Lead the monthly, quarterly, and annual close process across multiple entities and states.
• Oversee consolidated financial reporting, balance sheet reconciliations, accruals, intercompany accounting and eliminations, revenue recognition, fixed assets, leases, payroll accounting, and other key accounting processes.
• Ensure accurate and timely financial statements and management reporting.
• Establish standardized accounting procedures, policies, and documentation across entities.
• Continuously improve the speed, accuracy, and scalability of the financial close and reporting process.
• Identify and resolve accounting issues and ensure appropriate escalation when necessary.

Multi-Entity & Healthcare Finance

• Oversee financial reporting across the medical group, MSO, technology companies, and other affiliated entities.
• Manage intercompany accounting, management and service fee arrangements, cost allocations, and shared-service allocations.
• Develop entity-level, location-level, and operating-segment profitability reporting.
• Partner with Revenue Cycle and Operations to connect operational performance to financial results.
• Develop a strong understanding of healthcare revenue cycle drivers, including patient revenue, collections, A/R, payer performance, contractual adjustments, denials, and reimbursement.
• Determine whether financial variances are driven by accounting, revenue cycle, operations, or underlying business performance and work cross-functionally to address root causes.

FP&A & Business Performance

• Lead or support annual budgeting, rolling forecasts, cash forecasting, and financial planning.
• Conduct monthly variance analysis and provide clear explanations and recommendations to leadership.
• Develop financial dashboards, KPIs, and management reporting.
• Analyze profitability by entity, location, service line, payer, and other relevant business segments.
• Build financial models and scenario analyses to support strategic decisions.
• Support growth initiatives, acquisitions, new service lines, and other strategic business opportunities.
• Translate financial results into actionable recommendations for executive and operational leadership.

Finance Technology, Automation & AI

• Help modernize the Finance function and its technology infrastructure.
• Identify opportunities to automate manual processes, improve data integrity, streamline reporting, and reduce spreadsheet-dependent workflows.
• Partner with Technology and operational teams to improve integrations between accounting/ERP systems, practice management and revenue cycle platforms, payroll/HRIS, banking, accounts payable, expense management, and business intelligence tools.
• Evaluate and implement technology solutions that improve financial visibility, efficiency, and scalability.
• Champion the responsible use of automation, AI, and analytics to improve the speed, accuracy, and effectiveness of Finance.
• Help establish scalable data and reporting practices that can support continued organizational growth.

Internal Controls, Compliance & Audit

• Maintain an effective internal control environment, including approval structures, segregation of duties, reconciliations, and financial documentation.
• Develop and maintain accounting policies and procedures.
• Identify control weaknesses and implement corrective actions.
• Coordinate external audits, tax-related activities, banking requirements, lender reporting, insurance-related financial requests, and other external financial reporting.
• Partner with the CFO and external advisors on accounting, tax, compliance, and other financial matters.
• Ensure financial processes remain compliant with applicable accounting standards and regulatory requirements.

Cash & Working Capital Management

• Maintain strong visibility into cash flow and liquidity across the organization.
• Oversee or support cash forecasting, treasury processes, banking relationships, accounts payable, and working capital management.
• Connect revenue cycle and operational performance to cash flow and liquidity.
• Identify emerging cash flow risks and opportunities.
• Provide leadership with timely visibility into cash position and projected liquidity.

Leadership & Team Development

• Lead, develop, and mentor the accounting and finance team.
• Establish clear ownership, performance expectations, service standards, and accountability.
• Build a finance organization capable of scaling with the business without requiring headcount to increase proportionately with transaction volume.
• Develop standardized, repeatable, and well-documented processes that reduce reliance on individual institutional knowledge.
• Create strong cross-functional partnerships with Revenue Cycle, Operations, HR, Technology, Growth, and Clinical leadership.
• Foster a culture of continuous improvement in which Finance proactively identifies issues, opportunities, and recommended actions.

Strategic Partnership with the CFO

• Serve as a key strategic partner to the CFO on financial and operational matters.
• Support executive leadership with financial analysis, business cases, forecasting, and scenario planning.
• Help identify financial risks and opportunities before they become material issues.
• Provide leadership with a clear understanding of what happened, why it happened, what is likely to happen next, and what action should be taken.
• Participate in strategic planning and other initiatives that support the organization's growth and financial sustainability.

What You Bring

• 8-12+ years of progressive accounting and finance experience, including meaningful leadership responsibility.
• Bachelor's degree in Accounting, Finance, Business, or a related field.
• CPA and/or MBA preferred, but not required.
• Strong knowledge of GAAP, financial reporting, accounting operations, internal controls, and financial statement preparation.
• Demonstrated experience with multi-entity accounting and consolidations.
• Experience with budgeting, forecasting, financial modeling, and management reporting.
• Experience leading and developing accounting and finance teams.
• Strong analytical and problem-solving abilities with the ability to connect financial results to operational drivers.
• Demonstrated experience improving processes, implementing automation, and leveraging technology and data analytics.
• Strong communication skills and the ability to present complex financial information clearly to executive and operational leaders.
• Ability to work effectively in a fast-paced, high-growth environment with changing priorities.

Preferred Qualifications

• Healthcare finance experience, particularly within a physician group, MSO, multi-site healthcare organization, FQHC, or healthcare services company.
• Experience with healthcare revenue cycle finance, including revenue recognition, A/R, collections, payer performance, denials, contractual adjustments, and cash flow.
• Experience supporting acquisitions, integrations, or rapid organizational growth.
• Experience in a multi-state or geographically dispersed organization.
• Experience with ERP/accounting systems, financial reporting platforms, BI tools, and finance automation.
• Experience integrating financial data across multiple operational systems.
• Experience working with healthcare practice management and revenue cycle platforms.

What We Offer

• Competitive compensation
• Medical, dental, and vision insurance
• 401(k) program
• Paid time off
• Employee assistance program
• Professional development opportunities
• Collaborative, mission-driven work environment
• Opportunity to grow with a rapidly expanding healthcare organization
• Meaningful opportunity to influence organizational strategy and financial performance

Ideal Candidate

The ideal candidate is equally comfortable reviewing a balance sheet, analyzing the drivers behind a financial variance, working with an operational leader to solve a business problem, and identifying how technology can make Finance more efficient.

You are intellectually curious, highly accountable, and willing to be hands-on when necessary. You can move comfortably between detailed financial operations and broader business strategy.

Most importantly, you don't simply report financial results-you help leadership understand them, anticipate what comes next, identify opportunities and risks, and take action.