Director, RCM Balance Sheet Accounting

McKesson•Irving, TX

4d•$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, this role is the senior subject matter expert for substantiating practice accounts receivable, reserves, and related balances. The Director establishes standards that connect general ledger balances to source-system, subledger, bank, cash-transfer, and claim-level support; investigates material reconciling items; and ensures conclusions and accounting treatments are accurate, supportable, and clearly communicated. The Director partners with Practice Finance and Controller teams to improve practice accounts receivable balance sheet reconciliation processes and transition 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.

Requirements

A degree and typically 12 or more years of professional experience.
Four or more years of management experience.
Bachelor’s degree in Finance, Accounting, Business, Economics, or a related field, or equivalent related 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 AR, contractual and bad debt reserves, cash clearing, unapplied cash, and related general ledger balances.
Establish reconciliation standards that substantiate general ledger balances to source systems, subledgers, bank activity, cash transfers, and claim-level detail, including complete rollforwards, aging, reconciling-item support, ownership, and timely resolution.
Investigate 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 current reconciliation processes, identify gaps, and agree on 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 clear decision rights and escalation paths.
Own and oversee SOX controls related to 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, evaluated for financial impact, and resolved within established thresholds and timelines.
Partner with Controllership, Internal Audit, external auditors, Finance Systems, and process owners to maintain a proper control environment.
Lead and develop the RCM Balance Sheet Accounting team, 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, with timely escalation of material or aged items.
Build team capability through coaching, cross-training, documentation, quality reviews, and repeatable analytical and operating processes that reduce key-person dependency and improve consistency.
Lead or support projects requiring balance sheet accounting and reconciliation expertise.
Develop standardized templates, dashboards, and reporting to enhance balance sheet reconciliation processes.
Identify and implement technology and AI to improve consistency and efficiency.