Controller​/VP Finance

Vanguard Skin Specialists is a growing, physician-led medical group with a bold and purpose-driven mission: to deliver outstanding care while building a scalable, sustainable platform for multi-specialty services. With 9 locations, ~150 employees, and expanding operations – including a dermatology/plastic surgery/aesthetic services medical practice, an ambulatory surgery center in development, a real estate portfolio, and retail skincare business—we are entering our next phase of growth.

As the Controller/VP Finance, you will lead financial operations across multiple business lines, including our clinical practice, real estate holdings, retail skincare business, and upcoming ambulatory surgery center (ASC). This is a unique opportunity for someone who enjoys both building and leading – comfortable diving deep into accounting details one day and presenting strategy to executive leadership the next.

You will report directly to the CEO and serve as a core member of the executive team, helping shape our financial roadmap while building the infrastructure to scale. You will work closely with the COO and fractional CFO on strategic financial initiatives.

• Financial & Strategic Planning
  • Lead budgeting, forecasting, and financial modeling across all business entities.
  • Build and maintain dashboards, KPIs, and executive reports to drive decision-making and to monitor the financial health of the organization and each of the businesses.
  • Partner with CEO and COO on margin improvement, capital planning, and capital allocation strategy.
  • Lead cost structure analysis across the enterprise with the goal of identifying margin improvement through cost controls, revenue strategy, or operational efficiency.
  • Partner with CEO and COO for scenario models and ROI analyses for new investments, partnerships, and service lines.
  • Implement rolling 12-month cash flow forecast.
• Accounting & Reporting
  • Develop a high-integrity, efficient accounting foundation to support multi-entity operations and future audit-readiness.
  • Own the month-end close, general ledger oversight, and internal controls.
  • Generate accurate and timely financial reports including the following:
    Balance Sheet, P&L, Statement of Cash Flows across all business entities.
  • Work collaboratively with managers to develop budgets and forecasts for business units and to actively manage the practice to meet or exceed budget goals.
  • Report significant variation in financial results from prior periods and/or budget and provide commentary and analysis of financials. Identify causes of variances in financial results and recommend corrective actions.
  • Ensure compliance, tax readiness, and audit preparedness.
  • Oversee policies for expense tracking, revenue recognition, and entity-level allocations.
  • Lead reporting of key operational metrics including provider dashboard, impact scoreboard, and organizational KPIs.
• Internal Controls & Processes
  • Ensure scalable systems and processes that protect cash flow and reduce administrative overhead, especially as volume grows.
  • Establish and monitor appropriate internal control policies and procedures.
  • Ensure that the general ledger is supported by appropriate subsidiary ledgers and that all critical accounts are reconciled to subsidiary ledgers and third-party sources on a regular basis.
  • Establish appropriate segregations of duties and where such segregation is not practicable, implement compensating controls.
  • Oversee the A/R and A/P processes, ensuring optimal cash flow.
  • Oversee the payroll process to ensure payrolls are complete and accurate and that all related taxes and benefits are accounted for properly and that all required reporting is completed on a timely basis. Oversee related benefits of 401K, profit share program, and PTO.
  • Oversee all banking relationships and maintain treasury policies.
• Real Estate & Capital Projects
  • Oversee financial operations and reporting for a real estate portfolio.
  • Serve as financial lead for our ambulatory surgery center (ASC) development project, including pro forma modeling and budget oversight. Partner with legal, clinical, and construction teams to track ASC financial milestones.
  • Oversee…