Director of Finance

Medici•Austin, TX

3d•Onsite

About The Position

Medici is seeking a hands-on, strategic, and AI-forward Director of Finance to lead financial operations across Medici and affiliated businesses, including Health by Design. This role combines oversight of day-to-day accounting and finance with strategic partnership to executive leadership on budgeting, forecasting, cash flow management, financial reporting, and business decisions. A key focus is applying AI, automation, and modern financial technology to streamline accounting, improve reporting accuracy and controls, and build an efficient, scalable finance function. The role may grow into a VP of Finance position as the organization expands. The Director of Finance will oversee multi-entity accounting and financial operations, financial statements and close processes, billing and collections, accounts payable, payroll coordination, and financial systems. The position also leads and supports accounting personnel and improves collaboration between US operations and international accounting teams, while working with external accountants, auditors, and tax advisors as needed. The position requires onsite presence at the Austin clinic several days per week, with flexibility to travel to the San Antonio office, where most of the finance team is based. The company values in-person collaboration across both locations.

Requirements

Bachelor's degree in Accounting, Finance, or a related field.
At least 8 years of progressive accounting or finance experience, including financial management or leadership responsibilities.
Strong foundation in accounting principles, financial reporting, budgeting, forecasting, cash flow management, and financial controls.
Demonstrated experience overseeing accounts payable, accounts receivable, collections, payroll, and month-end close.
Experience partnering with executive leadership to provide financial analysis and strategic recommendations.
Proven ability to improve financial processes, reporting accuracy, and operational efficiency.
Experience managing or overseeing accounting and finance personnel.
Demonstrated experience leveraging AI, automation, or financial technology to improve finance and accounting workflows.
Strong analytical, problem-solving, communication, and organizational skills.
Ability to work independently, take ownership of outcomes, and thrive in a fast-paced, growth-stage environment.
Ability to work onsite at the Austin clinic several days per week and travel to the San Antonio office.

Nice To Haves

Experience with accounting and financial management systems; QuickBooks and Bill.com experience preferred.
Experience with multi-entity financial operations, recurring revenue, memberships, subscriptions, or healthcare billing.
CPA, MBA, or similar professional qualification; preferred but not required.

Responsibilities

Oversee accounting and financial operations across multiple Medici entities and affiliated businesses, including Health by Design.
Partner with the CEO and executive leadership on financial strategy, budgeting, forecasting, cash flow, and business planning.
Prepare and analyze financial statements, budgets, forecasts, and financial performance reports to support strategic decisions.
Monitor profitability, operating expenses, revenue trends, and financial performance across business entities.
Manage accounts receivable, including membership billing, service invoicing, payment reconciliation, collections, and account maintenance.
Develop and maintain scalable billing and collections processes to improve cash flow and reduce outstanding receivables.
Oversee accounts payable, vendor and contractor payments, employee reimbursements, and Bill.com workflows and approvals.
Maintain accurate financial records and oversee accounting activity within QuickBooks.
Lead month-end and year-end close processes, ensuring timely reconciliations, accurate reporting, and strong financial controls.
Develop cash flow forecasts, monitor financial obligations, and identify opportunities to improve financial performance.
Leverage AI, automation, and modern financial technology to streamline accounting workflows, improve reporting, and reduce manual processes.
Evaluate and implement financial systems, tools, and process improvements to support operational efficiency and scalability.
Oversee payroll coordination and ensure timely and accurate payments for employees and international contractors.
Provide leadership and oversight to accounting personnel and improve communication between US-based operations and international accounting teams.
Partner with external accountants, auditors, and tax advisors as needed.
Collaborate with Operations, Care Concierge, and leadership teams to improve billing accuracy, expense management, and financial reporting.
Identify financial risks, operational inefficiencies, and opportunities to improve profitability and support company growth.