Director of Finance chez Guaranteed Health

At Guaranteed Health we are on a mission to change the serious illness experience and are incredibly passionate about improving end-of-life care. We partner with health plans, providers, and other risk-bearing entities to improve outcomes for their highest acuity patients by deploying a value-based and AI-driven care navigation service. We are looking for people to join us on our mission, who are similarly obsessed with patient experience and delivering excellence in care.

Role Overview

The Director of Finance will oversee all financial operations across both the MSO and PC entities, ensuring clean separation, regulatory compliance, and accurate reporting. This role requires a mix of strategic financial leadership and hands-on execution, especially in setting up processes, systems, and controls where none currently exist. The Director of Finance will partner closely with the CEO, legal counsel, and outsourced finance providers (CFO advisors, accountants, RCM vendors) while building the foundation for an eventual in-house finance team.

Key Responsibilities:

Financial Management & Reporting

• Own the accounting and finance operations for both the MSO and PC.

• Ensure strict separation of entities, books, and accounts, in compliance with CPOM regulations.

• Manage outsourced bookkeeping and accounting partners, transitioning processes in-house where appropriate.

• Prepare monthly, quarterly, and annual financial statements (PC + MSO), plus consolidated management reports.

• Lead budgeting, forecasting, and financial planning, including scenario modeling for revenue and operating costs.

Revenue & Cash Flow Oversight

• Oversee revenue cycle processes (working with RCM vendors) to ensure accurate billing, collections, and reconciliation into the PC.

• Manage management fee transfers from PC to MSO per Management Services Agreement.

• Track physician compensation and distributions, ensuring alignment with fair market value and compliance rules.

• Maintain cash flow visibility across entities, ensuring liquidity and financial health.

Controls, Compliance & Risk Management

• Establish internal controls to prevent co-mingling of PC and MSO funds.

• Work with legal counsel to ensure compliance with fee-splitting, anti-kickback, and CPOM requirements.

• Manage tax strategy and filings in collaboration with external CPA firms.

• Prepare for audit readiness as the company scales.

Strategic Finance & Leadership

• Partner with the CEO and Head of Strategic Initiatives on growth strategy, fundraising readiness, and board reporting.

• Build financial models to support strategic decisions, including provider expansion, payer negotiations, and new market launches.

• Design finance KPIs and dashboards to track clinical (PC) and operational (MSO) performance.

Qualifications

• 10+ years of progressive finance/accounting experience, ideally with exposure to healthcare services and/or MSO/CPOM models.

• Hands-on experience in both strategic finance (FP&A, modeling, fundraising) and operational finance (GL, controls, compliance).

• Strong knowledge of healthcare reimbursement and revenue cycle.

• Demonstrated ability to build finance processes and teams from scratch in a high-growth environment.

• Excellent communication and leadership skills; comfortable presenting to executives, physicians, and board members.

What We’re Looking For

We need a builder: someone comfortable rolling up their sleeves on reconciliations and month-end close today, while laying the groundwork for a scalable finance function tomorrow. The right candidate will be excited by the challenge of working in a dual-entity CPOM environment, where compliance, precision, and growth strategy must all align.

Guaranteed is a proud Equal Opportunity Employer. We recruit, train, and compensate our team members based on their qualifications. We want to hear from you regardless of your race, religion, national origin, sex, gender identity, sexual orientation, disability, age, veteran status, or any other applicable legally protected characteristics.

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