Financial Controller (Nashville, TN)

Financial Controller

Position Overview

We are seeking an experienced, hands-on Financial Controller to lead accounting operations for a growing, multi-entity, multi-state healthcare organization. Reporting directly to the CFO, the Financial Controller will oversee financial close and reporting, revenue recognition, internal controls, treasury support, audits, and accounting system improvements.

The ideal candidate brings recent Controller experience within a large healthcare organization, strong technical accounting expertise, and the ability to balance strategic financial leadership with hands-on execution. This individual will lead a lean accounting team, strengthen financial processes, and support organizational growth in a fast-paced, private-equity-backed environment.

Key Responsibilities

• Financial Close and Reporting: Lead monthly, quarterly, and annual close processes across multiple entities, ensuring accurate, timely, GAAP-compliant financial statements prepared on an accrual basis. Maintain and improve a 10-business-day close cycle.
• Healthcare Revenue Recognition: Oversee revenue accounting, including ASC 606, contractual allowances, bad debt, payer-mix adjustments, reimbursement timing, and coordination with billing and revenue-cycle teams.
• Technical Accounting: Review journal entries, accruals, balance-sheet reconciliations, supporting schedules, fixed assets, capital projects, and lease accounting under ASC 842.
• Insurance and Risk Accruals: Calculate and review incurred-but-not-reported (IBNR) reserves and other insurance-related accruals associated with healthcare, workers’ compensation, automobile claims, and self-insurance programs.
• Team Leadership: Manage, mentor, and develop a lean accounting team responsible for accounts payable, accounts receivable, payroll, revenue accounting, and general accounting.
• Internal Controls and Compliance: Establish and maintain accounting policies, purchasing controls, AP approval hierarchies, payment workflows, and procedures that support financial accuracy and regulatory compliance.
• Accounting Systems and Automation: Lead accounting process improvements, reduce manual work, and improve reporting efficiency. Support NetSuite implementation or optimization, including system configuration, data migration, chart-of-accounts design, workflows, controls, and reporting.
• Consolidations and Cash Management: Oversee consolidated reporting across multiple entities and states. Prepare weekly cash-flow reports and partner with the CFO on liquidity planning, forecasting, and cash management strategies.
• Budgeting and Financial Analysis: Lead the annual budgeting process with operational leaders and prepare management reporting packages, operating analyses, forecasts, and ad hoc financial reports for executive leadership and investors.
• Audit Management: Lead annual financial statement audits and coordinate lender, insurance, tax, regulatory, and payer-related audits while maintaining an audit-ready general ledger and supporting documentation.
• Acquisitions and Integration: Support acquisition due diligence, purchase accounting, opening balance sheets, valuation coordination, and post-acquisition accounting integration.
• Risk Management: Collaborate with insurance brokers, actuaries, and auditors on renewals, exposure reporting, claims activity, and risk-management initiatives.
• Executive Partnership: Communicate financial results, accounting issues, and operational insights clearly to the CFO, executive leadership, private-equity stakeholders, auditors, and department leaders.

Qualifications

• Bachelor’s degree in Accounting, Finance, or a related field.
• Three to five years of recent experience as a Controller, preferably within a healthcare organization of comparable size and complexity.
• Strong healthcare accounting expertise, including revenue recognition and revenue-cycle accounting.
• Experience overseeing multi-entity, multi-state accounting operations and consolidated financial reporting.
• Proven ability to lead and develop a lean accounting team.
• Demonstrated success improving month-end close processes, implementing automation, and strengthening financial reporting.
• Experience preparing or reviewing IBNR reserves and other insurance-related accruals.
• Experience implementing or significantly optimizing NetSuite.
• Experience in a private-equity-backed organization or working directly with private-equity ownership.
• Strong knowledge of U.S. GAAP, including ASC 606, ASC 842, business combinations, and consolidations.
• Experience managing external audits and maintaining effective internal controls.
• Advanced Microsoft Excel skills and strong financial analysis capabilities.
• Excellent communication, leadership, organizational, and problem-solving skills.
• Ability to remain detail-oriented and effective in a fast-paced, demanding environment.

Preferred Qualifications

• Active Certified Public Accountant (CPA) license.
• Three to five years of public accounting or external audit experience, preferably with a Big Four or national accounting firm.
• Experience in EMS, ambulance services, hospitals, physician practices, or other provider-side healthcare organizations.
• Familiarity with Microsoft Dynamics 365 Business Central, Power BI, or similar financial reporting tools.
• Experience supporting acquisitions, purchase accounting, and post-acquisition integrations.