Director of Finance

Xterra Health is a fast-moving, mission-driven, remote-first veteran medical evidence and consulting organization headquartered in Salem, Ohio. We empower veterans through transparent access to the care, benefits, and support they've earned. Our teams review medical records, explain the VA disability claims process in plain language, and help veterans understand their options.

Guided by our ethos “service beyond self” and our motto “Stay mission ready,” we aim to become the nation's trusted leader in veteran healthcare advocacy and disability services.

Xterra Health is seeking a Director of Finance to turn our mission into a plan we can fund, measure, and grow. As the business scales, leadership is making decisions on where to invest, which services to expand, how fast to hire, and how much cash we need to get there. This senior FP&A leader will guide those decisions with rigorous financial insight.

The Director of Finance owns everything between clean books and confident decisions: budgets, forecasts, growth pro formas, product margins, P&L optimization, and cash flow forecasting. Reporting to the CAO, you will serve as their financial consultant and lead and develop the Finance & Accounting Manager. The title is Director, but the work is hands‑on. Success means leadership makes decisions from your analysis.

• Lead the annual budget and quarterly forecast cycle, partnering with department leads on organizational and departmental budgets
• Develop financial pro formas and scenario models to support growth initiatives, including service line expansion and workforce planning, with clearly defined assumptions and sensitivity analyses.
• Produce monthly variance analysis against budget and forecast, with narrative on what changed, why it matters, and recommended actions
• Maintain the KPI framework and executive reporting cadence
• Own the financial models that drive planning and keep them consistent across every decision

• Calculate and maintain product and service‑line margins, including direct provider and contractor costs and shared overhead
• Analyze the P&L for opportunities in pricing, cost structure, vendor terms, and mix, and present prioritized recommendations
• Evaluate the margin impact of proposed pricing changes, contracts, and new offerings before decisions are made

• Build and maintain a rolling 13‑week and longer‑range cash flow forecast covering AR collections, AP timing, payroll, contractor payments, and planned investments
• Monitor liquidity and working capital, and surface cash risks and funding needs early with recommended actions
• Reconcile forecast to actuals and refine the methodology over time

• Serve as financial consultant to the CAO and executive leadership on headcount, new markets, pricing, vendor contracts, and capital allocation
• Deliver monthly financial reporting, including P&L, cash position and forecast, AR/AP aging, and variance analysis
• Identify financial risks and opportunities proactively
• Partner with HR on compensation structure, benefits cost analysis, and workforce planning

• Lead and develop the Finance & Accounting Manager, with clear expectations, regular feedback, and a defined growth path
• Review expenditure categorization and chart of accounts usage to maintain general ledger accuracy
• Review and approve monthly close deliverables, including bank reconciliations, expense reports, and AR/AP aging
• Oversee payroll and 1099 tracking across a multi‑state contractor network

• Build the finance roadmap for scale, integrating existing…