Senior Grants Accountant (3513)

WACO FAMILY MEDICINE•Waco, TX

10d•Hybrid

About The Position

The Grants Accountant is a key finance partner responsible for the full lifecycle financial management of grant-funded programs within a nonprofit healthcare/FQHC environment. This role supports proposal budgeting, post-award financial oversight, compliance monitoring, subrecipient financial review, invoicing, reporting, and audit readiness. The ideal candidate combines strong technical accounting skills with the ability to collaborate closely with clinical leadership, program directors, compliance staff, and executive leadership to ensure grant funds are maximized, compliant, and strategically managed.

Requirements

Bachelor’s degree in Accounting, Finance, or related field
Minimum 4–7+ years accounting experience, including significant grant accounting responsibility
Experience working in nonprofit healthcare, FQHC, hospital system, or similarly regulated environment
Strong knowledge of fund accounting and restricted revenue tracking
Advanced Excel skills (budget modeling, pivot tables, reconciliation analysis)
Demonstrated ability to manage multiple complex funding sources simultaneously

Nice To Haves

Experience managing federal healthcare or large multi-program grant portfolios
Experience with subrecipient monitoring and compliance review
Familiarity with Uniform Guidance cost principles and grant compliance frameworks
Experience with nonprofit ERP/accounting systems
Ability to independently manage a complex grant portfolio with minimal supervision
Strong judgment in evaluating allowable vs. questionable expenses
Comfort working directly with clinical leadership and executive teams
Proactive communication style — identifies issues early and proposes solutions
High ownership mindset with strong documentation discipline
Ability to balance compliance rigor with operational practicality in a healthcare setting

Responsibilities

Grant Financial Oversight & Management
Manage assigned portfolio of federal, state, local, and foundation grants from award setup through closeout
Monitor budgets versus actual expenditures and proactively flag risks, underspending, or overspending
Review payroll allocations, purchase requests, contracts, and journal entries for allowability and proper coding
Maintain accurate tracking of restricted funds and grant-specific cost centers
Support month-end and year-end close processes related to grant activity
Grant Budget Development & Forecasting
Assist leadership and program teams in developing proposal budgets and budget narratives
Build detailed personnel cost models including fringe, allocation methodology, and funding splits
Support re-budgeting requests and financial modifications as grant scopes evolve
Provide ongoing projections and spending forecasts to program and finance leadership
Billing, Drawdowns, and Revenue Recognition
Prepare and submit grant invoices, reimbursement requests, and federal/state drawdowns
Maintain schedules of receivables and follow up on outstanding payments
Record grant revenue in accordance with nonprofit accounting standards and organizational policy
Ensure documentation supports all billed expenditures
Subrecipient Monitoring & Financial Compliance
Review subrecipient invoices and financial reports for compliance with contract terms and approved budgets
Ensure required documentation, supporting detail, and allowable cost standards are met prior to payment
Track subrecipient spending, reporting deadlines, and contract limits
Assist with risk assessment, monitoring documentation, and audit support for subawards
Compliance, Audit, and Documentation
Interpret grant agreements, notice of award terms, and reporting requirements
Maintain organized financial documentation for all grants to support internal and external audits
Prepare audit schedules and supporting documentation for annual financial audit and grant-specific reviews
Support implementation of strong internal controls related to restricted funding
Cross-Functional Partnership
Serve as a financial advisor to program managers and department leaders
Provide guidance on allowable expenses, documentation requirements, and spending timelines
Translate financial data into clear, actionable updates for non-finance staff
Partner with finance leadership on strategic planning related to funded programs