Reports To: Chief Executive Officer (CEO)

Works In Conjunction With: Chief Financial Officer (CFO)

Classification: Executive Leadership

Location: Conway SC Administrative Offices

Employment Type: Full-Time

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Position Summary

The Chief Accounting Officer (CAO) is a senior financial leader responsible for overseeing all accounting, financial reporting, and compliance functions of the Federally Qualified Health Center (FQHC). Reporting directly to the CEO, the CAO works in close collaboration with the Chief Financial Officer (CFO) to ensure the integrity of financial operations, regulatory compliance, and alignment with organizational financial strategy.

This role ensures compliance with federal, state, Medicare, and grant-related requirements while supporting the organization’s mission to provide high-quality, accessible healthcare services.

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Essential Duties and Responsibilities

Financial Leadership & Oversight

Lead all accounting operations, including general ledger, accounts payable and receivable, payroll, cash management, and internal controls.
Ensure accurate and timely preparation of monthly, quarterly, and annual financial statements in accordance with GAAP.
Collaborate closely with the CFO on budgeting, forecasting, financial analysis, and long-term financial planning.
Support enterprise-wide financial strategy and operational decision-making in coordination with the CFO.

Regulatory & Healthcare-Specific Reporting

Oversee financial components of Uniform Data System (UDS) measures, ensuring accuracy and compliance with HRSA requirements.
Manage preparation, submission, and reconciliation of Medicare Cost Reports.
Oversee calculation, tracking, and reporting of Medicare Credits.
Ensure timely and accurate submission of Federal Financial Reports (FFR).
Manage financial reporting requirements related to RMS (Reporting Management System).

Grant & Funding Management

Lead all aspects of grant financial management, including budgeting, expenditure tracking, compliance monitoring, and reporting.
Partner with program leadership and the CFO to ensure grant funding aligns with organizational and strategic priorities.
Serve as the primary accounting lead for grant audits, monitoring visits, and financial reviews.

Audit, Compliance & Risk Management

Lead external audits, including financial statement audits and Single Audits.
Ensure compliance with HRSA, CMS, and other federal and state regulatory requirements.
Maintain audit readiness and address findings in coordination with the CFO and executive leadership.

Leadership & Collaboration

Lead, mentor, and develop accounting and finance staff.
Work collaboratively with the CFO to align accounting operations with broader financial, operational, and strategic initiatives.
Provide financial insight and recommendations to the CEO, CFO, and Board of Directors.

Additional Responsibilities

Perform other duties as assigned to support organizational goals and compliance requirements.

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Qualifications

Experience

Minimum of five (5) years of progressive Chief or Director-level financial management experience in a healthcare organization.
Preferred: Previous experience in an FQHC or community health center environment.
Demonstrated experience with healthcare accounting, Medicare reimbursement, and grant management.

Education & Certification

Bachelor’s degree (BS) in Finance, Accounting, or a related field required.
Master’s degree in Finance or Business Administration (MBA) preferred.
Certified Public Accountant (CPA) certification required.

Physical Requirements & Working Conditions

Physical Demands:

o Mobility: Must be able to remain in a stationary position (seated) for extended periods (often 60-80% of the workday).

o Office Equipment: Frequent, repetitive use of hands and fingers to operate computers, keyboards, mice, printers, and phones.

o Lifting/Carrying: Occasional lifting or moving of documents, files, or light office equipment, generally weighing up to 10–20 pounds.

o Standing/Walking: Occasional standing and walking within the office to attend meetings, access files, or operate equipment.

o Communication: Specific vision abilities required include close vision, distance vision, and ability to adjust focus for reading documents and viewing computer screens. Must have the ability to speak clearly and hear effectively to communicate in person, via video conferencing, or over the telephone.

o Travel: Ability to travel locally or regionally to attend off-site meetings, city/council meetings, or visit work sites.

Work Environment:

o Primarily a climate-controlled, quiet-to-moderate noise office environment.

o Occasional exposure to high-pressure situations, tight deadlines, and frequent, intense contact with staff, high-profile individuals, or the public.

Accommodation: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

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Acknowledgment and Authorization

General Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. Management reserves the right to revise or change job duties and responsibilities as the need arises.

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