Director, RCM Balance Sheet Accounting

McKesson•Irving, TX

3d•$131,600 - $219,300•Hybrid

About The Position

The Director, RCM Balance Sheet Accounting provides leadership for The US Oncology Network’s practice accounts receivable and reserve balance sheet reconciliations. Reporting to the Senior Director, Revenue Cycle Management Finance, the Director is the senior subject matter expert for substantiating practice accounts receivable, reserves, and related balances. The role establishes standards connecting general ledger balances to source-system, subledger, bank, cash-transfer, and claim-level support; investigates material reconciling items; and ensures accounting conclusions are accurate, supportable, and clearly communicated. The Director partners with Practice Finance and Controller teams on practice accounts receivable reconciliation processes and transitions interested practice-owned reconciliations to a centralized RCM Balance Sheet Accounting team. This includes assessing current processes, defining data and support requirements, documenting optimal processes, and building a consistent, sustainable operating model. The role owns relevant SOX controls and leads the team responsible for recurring reconciliations, aging and reserve analysis, issue resolution, audit support, process improvement, and executive-ready reporting. This is a hybrid position. The selected candidate is expected to work on-site at the Las Colinas office at least two days per week, with the remaining days worked remotely. In-office days may be designated based on team needs and business priorities.

Requirements

Bachelor’s degree in Finance, Accounting, Business, Economics, or a related field, or equivalent related experience.
Typically requires 12 or more years of professional experience.
Requires 4 or more years of management experience.

Nice To Haves

MBA, CPA, CMA, or another relevant advanced credential.

Responsibilities

Serve as the senior subject matter expert for practice accounts receivable and reserve balance sheet reconciliations, including patient and pharmacy accounts receivable, contractual and bad debt reserves, cash clearing, unapplied cash, and related general ledger balances.
Establish reconciliation standards connecting general ledger balances to source systems, subledgers, bank activity, cash transfers, and claim-level detail; require complete rollforwards, aging, reconciling-item support, ownership, and timely resolution.
Lead investigations of complex or unsupported balances, challenge unvalidated assumptions, determine appropriate accounting treatment, and communicate financial risk, remediation plans, and findings to executives.
Partner with Practice Controllers, Regional Finance Directors, and practice leadership to assess reconciliation processes, identify gaps, and determine transition readiness.
Design and execute phased transitions of practice accounts receivable reconciliations to the centralized team, including migration plans, standardized templates, knowledge transfer, training, acceptance criteria, service expectations, and post-transition stabilization.
Build partnerships across Practice Finance, Accounting, Controllership, Revenue Cycle Operations, Treasury, Finance Systems, and data teams to resolve reconciling items, improve upstream processes, and maintain decision rights and escalation paths.
Own and oversee SOX controls for accounts receivable, reserves, and related balance sheet reconciliations, including control design and execution, reviewer evidence, issue identification, remediation, and change management.
Maintain audit-ready policies, procedures, account ownership, reconciliation standards, and supporting documentation; ensure reconciling items are aged, assigned, assessed for financial impact, and resolved within established thresholds and timelines.
Partner with Controllership, Internal Audit, external auditors, Finance Systems, and process owners to maintain an appropriate control environment.
Lead and develop the RCM Balance Sheet Accounting team by establishing account ownership, priorities, review standards, close calendars, performance expectations, and a scalable operating model across practices.
Prioritize team capacity across recurring reconciliations, issue resolution, SOX requirements, audit support, and emerging financial risks; escalate material or aged items promptly.
Develop team capabilities through coaching, cross-training, documentation, quality reviews, and repeatable analytical and operating processes.
Lead or support projects requiring balance sheet accounting and reconciliation expertise.
Develop standardized templates, dashboards, and reports to enhance balance sheet reconciliation processes.
Identify and implement technology and AI use to improve consistency and efficiency.