Director of Finance - Healthcare

Location: Chula Vista, United States Keller Executive Search is partnering with an established nonprofit community health organization to appoint a Finance Director. Operating within the Federally Qualified Health Center (FQHC) sector, our client provides accessible healthcare while navigating complex reimbursement, funding, and regulatory requirements. The Finance Director will oversee all financial operations, including reporting, budgeting, forecasting, reimbursement, cash management, audits, internal controls, and compliance. The role requires strong, hands-on FQHC expertise, particularly in UDS reporting, PPS reimbursement, Medicare and Medi-Cal cost reporting, HRSA requirements, and Sliding Fee Discount Program oversight. Working closely with executive leadership and the Board, the successful candidate will provide strategic financial guidance, lead and develop the finance team, strengthen financial systems and controls, and support the organization's long-term financial sustainability. Key Responsibilities Lead the finance department and maintain timely, accurate, and compliant financial operations Direct monthly, quarterly, and annual close, financial statements, management reporting, and variance analysis Lead operating and capital budgeting, forecasting, cash-flow planning, and financial analysis Oversee UDS financial and statistical reporting and its reconciliation with accounting and encounter data Direct Medicare and Medi-Cal cost reporting, reconciliations, settlement reviews, and applicable HCAI reporting Lead PPS rate and reimbursement analysis using encounter data, allowable costs, payer trends, and change-in-scope considerations Oversee the financial administration and HRSA compliance of the Sliding Fee Discount Program Analyze payer mix, reimbursement, visit trends, revenue-cycle performance, costs, and financial risks Oversee the general ledger, accounts payable, accounts receivable, payroll coordination, and cash management Strengthen accounting policies, procedures, internal controls, and financial reporting systems Lead audit preparation and serve as the primary finance liaison with auditors, grantors, payers, and regulators Advise executive leadership, operational leaders, and the Board on performance and financial decisions Lead, mentor, and develop finance staff while documenting critical processes and building backup capacity Requirements Bachelor's degree in Accounting, Finance, Business Administration, or a related field At least 7 years of progressive accounting or finance experience At least 3 years of healthcare finance leadership or management experience Strong applied FQHC finance expertise, including UDS, PPS reimbursement, Medicare cost reporting, HRSA requirements, and Sliding Fee Discount Program oversight Demonstrated ability to independently direct a healthcare finance function spanning close, reporting, budgeting, cash management, audits, and controls Strong knowledge of GAAP, healthcare reimbursement, regulatory financial compliance, and grant-supported operations Strong analytical, organizational, leadership, and executive communication skills Existing authorization to work in the United States without employer sponsorship Ability to work full-time on site in Chula Vista, California Preferred Three or more years within an FQHC, community health center, or comparable safety-net healthcare organization Experience with HCAI reporting, Medi-Cal cost reporting, reconciliations, and settlement review HRSA Section 330 grant management, Uniform Guidance, single-audit, or operational site visit experience PPS rate-setting and change-in-scope analysis experience Finance leadership across multiple healthcare sites or service lines Previous direct supervision of finance or accounting staff CPA, MBA, MHA, or another relevant advanced credential Advanced Microsoft Excel and accounting or financial reporting systems proficiency Benefits Salary: $160000 – $200000 Health, dental, and vision insurance 401(k) or retirement plan match Paid time off Life and disability insurance Relocation assistance Agency statement Keller is a recruitment agency serving clients from startups and non profits to multinational corporations, emphasizing ethical search processes, attentive candidate care, and leadership placements that support long-term client outcomes. 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