Director of Finance

Xterra Health is seeking a Director of Finance to turn our mission into a plan we can fund, measure, and grow. As the business scales, leadership is making decisions on where to invest, which services to expand, how fast to hire, and how much cash we need to get there. This senior FP&A leader will guide those decisions with rigorous financial insight. The Director of Finance owns everything between clean books and confident decisions: budgets, forecasts, growth pro formas, product margins, P&L optimization, and cash flow forecasting. Reporting to the CAO, you will serve as their financial consultant and lead and develop the Finance & Accounting Manager. The title is Director, but the work is hands-on. Success means leadership makes decisions from your analysis. Responsibilities Financial Planning & Analysis • Lead the annual budget and quarterly forecast cycle, partnering with department leads on organizational and departmental budgets • Develop financial pro formas and scenario models to support growth initiatives, including service line expansion and workforce planning, with clearly defined assumptions and sensitivity analyses. • Produce monthly variance analysis against budget and forecast, with narrative on what changed, why it matters, and recommended actions • Maintain the KPI framework and executive reporting cadence • Own the financial models that drive planning and keep them consistent across every decision Margin Analysis & P&L Optimization • Calculate and maintain product and service-line margins, including direct provider and contractor costs and shared overhead • Analyze the P&L for opportunities in pricing, cost structure, vendor terms, and mix, and present prioritized recommendations • Evaluate the margin impact of proposed pricing changes, contracts, and new offerings before decisions are made Cash Flow Forecasting • Build and maintain a rolling 13-week and longer-range cash flow forecast covering AR collections, AP timing, payroll, contractor payments, and planned investments • Monitor liquidity and working capital, and surface cash risks and funding needs early with recommended actions • Reconcile forecast to actuals and refine the methodology over time Financial Consulting & Executive Partnership • Serve as financial consultant to the CAO and executive leadership on headcount, new markets, pricing, vendor contracts, and capital allocation • Deliver monthly financial reporting, including P&L, cash position and forecast, AR/AP aging, and variance analysis • Identify financial risks and opportunities proactively • Partner with HR on compensation structure, benefits cost analysis, and workforce planning Accounting Oversight & Team Leadership • Lead and develop the Finance & Accounting Manager, with clear expectations, regular feedback, and a defined growth path • Review expenditure categorization and chart of accounts usage to maintain general ledger accuracy • Review and approve monthly close deliverables, including bank reconciliations, expense reports, and AR/AP aging • Oversee payroll and 1099 tracking across a multi-state contractor network Financial Systems & Infrastructure • Build the finance roadmap for scale, integrating existing platforms, including QuickBooks, into a connected reporting environment • Design internal controls, approval flows, and documentation standards that scale with growth • Lead system integrations and process improvements from planning through adoption Required • 7+ years of progressive finance and accounting experience, including 4+ years in a dedicated FP&A role and 2+ years leading a finance function • Bachelor's degree in Finance, Accounting, Economics, or a related field, or equivalent professional experience • Demonstrated success leading financial operations within a small business, start-up, or high-growth organization, with the ability to build scalable processes and infrastructure • Advanced FP&A expertise, including budgeting, multi-period forecasting, scenario modeling, P&L and margin analysis, cash flow forecasting, and working capital management • Comprehensive knowledge of GAAP, accounting principles, financial reporting, and internal controls • Advanced Excel skills and hands-on experience with QuickBooks (Online or Desktop) • Proven ability to serve as a strategic financial partner to executive leadership, translating complex analysis into clear, actionable recommendations while maintaining discretion with confidential compensation, personnel, and financial data • Experience leading, developing, and mentoring finance and accounting professionals • Note: Occasional Travel to Salem, Ohio is required Preferred • CPA, CFA, or MBA in Finance or a related discipline • Experience in healthcare, government services, or another regulated industry • Experience supporting financial operations across multiple states and a blended employee and contractor workforce • Experience implementing or improving financial systems, reporting processes, and operational controls to support organizational growth Compensation & Benefits • Base salary: $150,000 - $180,000, commensurate with experience • Medical, Dental & Vision: Eligible the first of the month following 30 days; Xterra Health covers 75% of employee premiums • Unlimited PTO, plus 10 paid company holidays • 401(k): 100% employer match up to 4% of eligible compensation; immediate vesting; enrollment the first of the month following 90 days • Remote work arrangement with occasional travel to company headquarters in Salem, Ohio