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Controller

Reports to: CFO
Department: Corporate Accounting
Travel: 15%
Work Arrangement: Remote Opportunity

About MedHQ

MedHQ is healthcare’s leading provider of operational and management services partnering with health systems, ambulatory surgery centers (ASC), and physician groups. Its offerings include advisory services, ASC and physician practice management, and administrative services such as HR, revenue cycle, and financial services.

Position Summary

The Controller is a critical member of MedHQ's finance leadership, responsible for the accuracy, integrity, and efficiency of the company's accounting legal entities. This is a hands-on leadership role for a builder — someone who can establish rigorous financial controls, drive a clean monthly close, and serve as a strategic finance partner to operational and executive leadership. The Controller reports to the CFO and works closely with HR, Operations, and service line leaders across the organization.

Key Responsibilities

Financial Reporting & Close

• Own the monthly, quarterly, and annual close process across all MedHQ entities and service lines.
• Prepare accurate, GAAP-compliant financial statements and management reporting packages.
• Manage intercompany allocations and consolidated reporting across service lines.
• Maintain a disciplined close calendar and drive accountability across the accounting function.

Accounting Operations

• Oversee general ledger, accounts payable, accounts receivable, and payroll accounting.
• Ensure accurate revenue recognition across MedHQ's shared service model — RCM, HR client services, accounting services, and advisory.
• Partner with HR/People Ops on payroll accounting accuracy across a multi-state, multi-entity workforce (PrismHR).
• Maintain the chart of accounts and enforce consistent coding practices across all entities.

Controls & Compliance

• Design, implement, and maintain internal controls appropriate for a multi-entity shared services organization.
• Ensure compliance with federal, state, and local tax requirements across jurisdictions as the business grows.
• Coordinate with external auditors, tax advisors, and banking partners.

Financial Planning & Business Partnership

• Partner with leadership on annual budgeting, rolling forecasts, and variance analysis.
• Provide financial analysis and insight to support decisions around service line performance, pricing, capacity, and growth.
• Support financial modeling and due diligence for acquisitions, integrations, and new service line development.
• Translate financial data into clear, actionable reporting for non-finance stakeholders.

Team & Systems Leadership

• Lead, manage, and develop a team of 4–5 direct reports; define roles and build capacity as the organization scales.
• Evaluate, implement, and improve accounting systems and workflows to support a growing shared services platform.
• Partner cross-functionally with HR, Operations, and TA on finance-adjacent work including headcount planning, cost center management, and contractor vs. employee classification.
• Travel approximately 15% as needed to support business operations, team collaboration, and organizational initiatives.

Qualifications & Requirements

• Bachelor’s degree in accounting, Finance, or related field.
• 7+ years of progressive accounting experience, with 3+ years in a Controller or Assistant Controller role.
• Experience in a multi-entity or multi-state environment.
• Strong technical accounting knowledge including GAAP, revenue recognition, intercompany transactions, and cost allocation.
• Experience managing payroll accounting in a complex, multi-state workforce environment.
• Proficiency with accounting software and strong Excel skills.
• Demonstrated experience leading and developing an accounting team.

Preferred

• Hands-on experience with PrismHR.
• Experience in healthcare services, shared services, or RCM.
• Background with acquisition integration and purchase accounting.
• Experience designing and scaling accounting infrastructure in a high-growth or private equity-backed environment.
• Preferred Location: Nashville & Dallas Areas