Director, RCM Balance Sheet Accounting

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Role Overview

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 serves as the senior subject matter expert for substantiating practice accounts receivable, reserves and other 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 will partner with Practice Finance and Controller teams on practice Accounts Receivable balance sheet reconciliation processes and to transition interested practice-owned accounts receivable reconciliations to a centralized RCM Balance Sheet Accounting team. This includes assessing current-state processes, defining data and support requirements, documenting optimal processes and building a consistent, sustainable operating model.

The role also 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.

Key Responsibilities

• Accounts Receivable and Reserve Balance Sheet Reconciliation Expertise
• 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; require complete rollforwards, aging, reconciling-item support, ownership, and timely resolution.
• Lead investigation of complex or unsupported balances, challenge unvalidated assumptions, determine appropriate accounting treatment, and translate findings into clear financial risk, remediation plans, and executive-level updates.
• Practice Reconciliation Centralization and Partnership
• Partner with Practice Controllers, Regional Finance Directors, and practice leadership to assess current reconciliation processes, identify gaps in data, documentation, ownership, and control execution, and agree on transition readiness.
• Design and execute the phased transition of practice accounts receivable reconciliations to this centralized team, including migration plans, standardized templates, knowledge transfer, training, acceptance criteria, service expectations, and post-transition stabilization.
• Build durable 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.
• Sarbanes-Oxley and Balance Sheet Control Ownership
• Own and oversee SOX controls related to accounts receivable, reserves, and related balance sheet reconciliations, including control design, 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.
• Team Management and Prioritization
• 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 development of repeatable analytical and operating processes that reduce key-person dependency and improve consistency.
• Other Ad Hoc Project Work
• Lead or support projects requiring balance sheet accounting and reconciliation expertise.
• Develop standardized templates, dashboards, reporting, etc. to enhance balance sheet reconciliation processes.
• Identify and implement use of Technology and AI to drive consistency and efficiency in the processes.
• Minimum Requirement
• Degree and typically requires 12+ years of professional experience and 4+ years of management experience.
• Education
• Bachelor’s degree in Finance, Accounting, Business, Economics, or a related field, or equivalent related experience.
• MBA, CPA, CMA, or other relevant advanced credential preferred.