Director of Finance (Healthcare)

Belle•Jacksonville, FL

About The Position

Belle delivers high-touch in-home care to Medicare members using a novel Community Health Worker (CHW)-led model, supported by telehealth clinicians and a comprehensive CCM program. We are scaling rapidly across states and transitioning into a full MSO + multi-medical group architecture. We’re entering the next phase of growth — multi-state expansion, payer contracting, and significant operational scale. Belle needs a hands-on financial builder to architect and own our financial foundation. Purpose of this Role Belle is hiring its first Director of Finance — a hands-on operator who can build, implement, and run our multi-entity financial system across an MSO and several physician-owned medical groups. This person will play a foundational role in designing Belle’s financial infrastructure, implementing systems, managing cash, supporting payer economics, and building the reporting engine that drives our national expansion. You’ll work directly with the CEO and have support from a part-time external bookkeeper and Practice Manager (who owns daily RCM/claims operations) This is a high-autonomy, high-impact role for someone who loves building from scratch and wants to grow into VP of Finance over time.

Requirements

6–10+ years experience in finance/accounting roles
Must have: Strong background in healthcare provider, MSO, medical group finance
Experience with multi-entity organizational structures
Hands-on — you’re comfortable building models, running systems, closing the books, and architecting financial flows
Strong command of GAAP, accounting processes, and financial controls
Fluent in Excel/Sheets and familiar with tools like QuickBooks, Sage Intacct, Ramp
Comfortable working directly with a founder, moving quickly, and creating order from ambiguity
Excellent communicator who can explain complex financial concepts simply
Hungry to grow into a VP-level role as the company scales

Nice To Haves

Preferred: Strong background in VBC, telehealth, home-based care

Responsibilities

Multi-Entity Financial Architecture
Build and maintain the financial structure across the MSO and multiple state medical groups (GA, MI, MO, etc.).
Set up intercompany allocations, clinical fees, management fees, and compliance-aligned financial flows.
Ensure each entity has clean financial separation (CPOM compliance).
Accounting & Systems Implementation
Own the migration from QuickBooks Online to a multi-entity accounting system.
Build charts of accounts, entity separation, and consolidated reporting frameworks.
Establish strong financial controls, treasury rules, and monthly close processes.
Revenue Cycle & Payer Finance
Partner closely with the Practice Manager to align RCM operations with financial reporting.
Audit payer reimbursements, AR, and remittances to ensure accurate cash flow.
Support payer contracting and pricing using PMPM cost modeling and state-level unit economics.
FP&A, Forecasting & Analytics
Manage Belle’s financial forecast model for growth, staffing, cash flow and new markets.
Own recurring reporting: budgets, variance analysis, dashboards, cash runway, and KPI performance.
Analyze clinical cost structure by state and support expansion decisions.
Treasury & Cash Management
Oversee financial operations across all entities (Ramp Treasury accounts, intercompany transfers, payroll entity separation).
Ensure correct funds flow between MSO and medical groups.
Manage liquidity, reserves, and financial risk.
Compliance, Audit & Controls
Maintain GAAP-compliant financials across all entities.
Prepare the company for future audits, payer credentialing reviews, and investor diligence.
Implement robust internal controls as Belle scales.
Build the Future Finance Organization
Initially run point as a one-person department (with bookkeeper + PM support).
Over time, hire and develop key roles.
Establish a high-trust, high-clarity financial culture.