Financial Controller

About the role

Ambience Healthcare is seeking a highly experienced Financial Controller to establish and scale a top-tier accounting function within the company. This role is critical in managing the monthly financial close process, ensuring adherence to internal controls, and maintaining tax compliance across various jurisdictions. The successful candidate will oversee the external audit process annually, ensuring smooth coordination and compliance, and will work closely with senior leadership to develop and implement the company's financial strategy. You will also be responsible for building and leading a high-performing accounting team, supporting strategic initiatives, and collaborating with multiple departments to align financial practices with company growth objectives. This position offers an to shape the financial infrastructure of a fast-growing healthcare SaaS company, contributing directly to its operational success and strategic planning.

Key facts

What you'll do

• Oversee and manage the entire monthly financial close process, ensuring all financial statements are accurate, complete, and compliant with U.S. GAAP standards.
• Lead the planning, preparation, and coordination of the annual external audit, including liaising with auditors, preparing necessary documentation, and ensuring all internal controls and reconciliations are in place.
• Develop, implement, and maintain core accounting policies related to revenue recognition (ASC 606), expense management, capitalization, and lease accounting (ASC 842), ensuring compliance with relevant standards and regulations.
• Manage indirect tax compliance activities, including multi-state SaaS nexus analysis, registration, and remittance processes, working closely with external tax advisors to ensure timely and accurate filings.
• Oversee treasury functions such as cash management, disbursements, banking relationships, and liquidity planning to support operational needs and strategic initiatives.
• Evaluate existing accounting systems and automation tools, identifying opportunities for process improvements and deploying solutions that streamline the order-to-cash cycle, including optimizing the deal desk operations.
• Build, develop, and lead the accounting team, supervising outsourced bookkeeping, review processes, and reconciliation activities to ensure accuracy and efficiency.
• Collaborate with finance and operations teams to perform variance analysis, pipeline-to-ARR tracking, and prepare management discussion and analysis reports for leadership and the Board of Directors.
• Partner with the VP Finance to develop and execute the company's financial strategy, including preparing reports for the Board, and establishing infrastructure to support rapid growth.
• Work closely with Legal, Deal Desk, People, and Product teams to ensure accounting practices align with new contracts, headcount changes, and product launches, maintaining compliance and supporting operational scaling.
• Support initiatives to improve financial reporting, internal controls, and compliance processes, ensuring the company adheres to regulatory requirements and best practices.
• Assist in the evaluation and deployment of new financial systems, tools, and automation solutions to enhance efficiency and scalability of financial operations.
• Provide mentorship and guidance to junior accounting staff and external partners, fostering a culture of accuracy, compliance, and continuous improvement.

Requirements

• A minimum of 8 or more years of progressive accounting experience, with a proven track record in high-growth environments.
• At least 2 years in a Controller or Assistant Controller role within a venture-backed or rapidly scaling company, preferably in SaaS or healthcare sectors.
• Extensive knowledge of U.S. GAAP accounting standards, including revenue recognition (ASC 606), lease accounting (ASC 842), and stock-based compensation.
• Demonstrated experience leading or supporting external audits, including preparation, documentation, and internal controls.
• Proven ability to build and scale accounting processes, including selecting and implementing accounting systems and automation tools.
• Strong cross-functional communication skills, with the ability to explain complex accounting concepts to non-finance stakeholders clearly and effectively.
• CPA certification is required, with public accounting experience at a Big 4 or national firm strongly preferred.
• Experience managing indirect tax compliance, multi-state SaaS nexus analysis, and remittances.
• Familiarity with treasury functions, cash management, and banking relationships.
• Ability to work in a fast-paced environment, managing multiple priorities with attention to detail and accuracy.
• Strong leadership skills, with experience building and managing accounting teams and external partnerships.

Nice to have

• Experience leading an annual audit at a venture-backed company, particularly Series B-D funding rounds.
• Familiarity with NetSuite or similar ERP systems, along with modern close management and automation tools.
• Background in healthcare or SaaS revenue recognition, with an understanding of industry-specific accounting practices.
• Knowledge of compliance requirements related to healthcare SaaS companies, including relevant industry standards and regulations.
• Experience working with international teams or managing multi-jurisdictional tax compliance.
• Ability to adapt quickly to changing business needs and contribute to strategic initiatives beyond traditional accounting functions.

Skills & tools

• U.S. GAAP
• ASC 606 (Revenue Recognition)
• ASC 842 (Leases)
• NetSuite (or comparable ERP systems)
• Experience with automation tools and financial systems deployment

Practical notes

an on-site role based in the San Francisco Bay Area, requiring candidates to be located locally or willing to relocate. The company offers a competitive salary aligned with experience, along with meaningful equity grants as part of the compensation package. Benefits include comprehensive medical, dental, and vision coverage, a 401(k) plan with company matching up to 3%, parental leave, flexible time off policies, and an annual holiday shutdown. The company is committed to fostering an inclusive environment and provides accommodations for candidates with disabilities. Candidates should be prepared to work in a collaborative, fast-paced environment that values accuracy, compliance, and strategic thinking.

About the company

Here at Ambience, we never set out to be just another scribe. We're building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country.