Controller — Multi-State Healthcare Enterprise

Controller — Multi-State Healthcare Enterprise Department: Accounting & Finance Reports To: Chief Financial Officer Role Type: Accounting & Financial Leadership Scope: Multi-state medical group, MSO, and affiliated technology and service companies Position Summary The Controller is responsible for leading the accounting operations, financial reporting, internal controls, and financial analysis of a complex, multi-entity healthcare enterprise.

This position requires a strong technical accounting foundation, demonstrated controllership experience, and the ability to oversee all aspects of the general ledger, financial close, reconciliations, and consolidated financial reporting across multiple entities. The Controller will ensure the accuracy, integrity, and timeliness of financial information while developing scalable accounting processes, maintaining effective internal controls, and supporting financial analysis that provides actionable insights into business performance.

Reporting directly to the CFO, the Controller will lead the accounting team and work closely with Revenue Cycle, Operations, Technology, HR, and other functional leaders to ensure financial accuracy, operational accountability, and continuous improvement. The successful candidate will be an experienced, hands-on accounting leader who combines the technical expertise and discipline of a traditional Controller with strong analytical capabilities and a continuous improvement mindset.

Key Responsibilities

Accounting Operations, Close & Financial Reporting Own and manage all aspects of the general ledger and monthly, quarterly, and annual financial close processes across multiple entities and states. Ensure the timely and accurate preparation of financial statements, including consolidated and entity-level income statements, balance sheets, and cash flow reporting.

Oversee journal entries, accruals, account reconciliations, intercompany accounting and eliminations, revenue recognition, fixed assets, leases, payroll accounting, and other key accounting functions. Maintain appropriate accounting policies and ensure compliance with U.S. GAAP and applicable financial reporting standards.

Review financial results, investigate unusual balances or transactions, and ensure the completeness and accuracy of financial reporting. Continuously improve the efficiency, consistency, and timeliness of the financial close process. Multi-Entity Accounting & Financial Management Oversee accounting and financial reporting across the medical group, MSO, technology companies, and other affiliated entities.

Manage intercompany transactions, management and service fees, shared-service cost allocations, and consolidated financial reporting. Ensure appropriate accounting treatment, documentation, and reconciliation of intercompany balances and transactions. Maintain accurate entity-level financial reporting and support analysis of profitability across the organization.

Healthcare Revenue Accounting & Revenue Cycle Oversee the accounting and financial reporting associated with healthcare revenue, including net patient revenue, contractual allowances, accounts receivable, and related reserves. Ensure appropriate reconciliation between revenue cycle systems, accounts receivable reporting, cash collections, and the general ledger.

Partner with Revenue Cycle leadership to understand revenue trends, collection performance, adjustments, denials, and other factors affecting financial results. Identify and investigate variances between expected and actual revenue, distinguishing accounting issues from revenue cycle timing or operational performance issues.

Financial Analysis & Business Performance Prepare and review monthly financial results, including budget-to-actual comparisons, historical trends, and explanations of significant variances. Partner with the CFO to support budgeting, forecasting, cash flow projections, profitability analysis, and other financial planning activities.

Analyze financial and operational performance to identify trends, risks, opportunities, and areas requiring management attention. Develop meaningful financial reporting that provides visibility into performance by entity, market, department, and other relevant operating segments. Translate financial results into clear explanations of what happened, why it happened, and what actions may be needed to improve performance.

Internal Controls, Compliance & Audit Establish and maintain strong internal accounting controls, including appropriate approval processes, segregation of duties, reconciliations, and supporting documentation. Ensure compliance with established accounting policies and financial reporting requirements. Coordinate external audits, tax preparation support, lender reporting, and other external financial reporting requirements.

Identify accounting risks and implement corrective actions to strengthen financial accuracy and control. Cash Management & Working Capital Oversee cash reconciliations, accounts payable, and related accounting processes. Support cash flow forecasting, working capital management, banking activities, and liquidity reporting.

Monitor cash activity and coordinate with Revenue Cycle and operational leaders to understand significant fluctuations in collections and cash flow. Accounting Systems, Process Improvement & Automation Maintain the integrity of accounting systems, financial data, and related reporting processes. Identify opportunities to improve accounting workflows, automate reconciliations and reporting, and reduce manual processes.

Partner with Technology and other departments to improve financial system integrations, data accuracy, and reporting capabilities. Leverage accounting technology, automation, and analytical tools to improve the efficiency, accuracy, and scalability of the accounting function. Leadership & Team Development Lead, mentor, and develop the accounting team, establishing clear responsibilities, performance expectations, and accountability.

Provide hands-on technical accounting guidance and oversight to ensure the quality and accuracy of the team's work. Establish standardized accounting procedures, documentation, and financial close schedules across the organization. Build a scalable accounting function capable of supporting organizational growth, additional entities, and increasing transaction complexity.

Foster a culture of accuracy, accountability, continuous improvement, and proactive problem-solving.

Qualifications

Bachelor's degree in Accounting or Finance required, with a strong foundation in accounting principles and financial reporting. CPA strongly preferred. 8–12+ years of progressive accounting experience, including significant experience as a Controller, Assistant Controller, Accounting Director, or similar accounting leadership role.

Strong technical accounting knowledge, including U.S. GAAP, general ledger management, financial statement preparation, consolidations, and internal controls. Demonstrated experience independently managing the monthly financial close and overseeing the preparation and review of accurate financial statements. Experience managing multi-entity accounting, intercompany transactions, and consolidated financial reporting.

Proven ability to lead and develop accounting teams while remaining hands-on with complex accounting issues. Strong financial analysis skills, including variance analysis, budgeting support, financial reporting, and the ability to interpret financial performance. Proficiency with ERP/accounting systems, advanced Excel, and financial reporting tools.

Demonstrated success improving accounting processes, internal controls, and reporting efficiency. Healthcare industry experience preferred, particularly physician groups, MSOs, multi-site healthcare organizations, or other healthcare services businesses. Experience with healthcare revenue recognition, patient accounts receivable, and revenue cycle accounting is highly desirable.

Experience in rapidly growing, multi-entity, or geographically dispersed organizations preferred. Ideal Candidate The ideal candidate is an experienced accounting leader with a strong technical foundation and a proven track record of managing the financial close, general ledger, and financial reporting for a complex organization.

This individual is comfortable working at both a detailed and strategic level—capable of resolving complex accounting issues, ensuring accurate financial statements, developing a strong accounting team, and analyzing financial results to support business decisions. The successful Controller will be accountable for the numbers, capable of explaining the numbers, and proactive in identifying opportunities to improve financial performance and accounting operations.