Senior Grants Accountant Waco LilyLifestyle

Grants Accountant (Mid-Senior Level) - Federally Qualified Health Center (FQHC) Position Overview

The Grants Accountant is a key finance partner responsible for the full lifecycle financial management of grant‑funded programs within a nonprofit healthcare/FQHC environment. This role supports proposal budgeting, post‑award financial oversight, compliance monitoring, subrecipient financial review, invoicing, reporting, and audit readiness.

The ideal candidate combines strong technical accounting skills with the ability to collaborate closely with clinical leadership, program directors, compliance staff, and executive leadership to ensure grant funds are maximized, compliant, and strategically managed.

• Manage assigned portfolio of federal, state, local, and foundation grants from award setup through closeout.
• Monitor budgets versus actual expenditures and proactively flag risks, under spending, or overspending.
• Review payroll allocations, purchase requests, contracts, and journal entries for allowability and proper coding.
• Maintain accurate tracking of restricted funds and grant‑specific cost centers.
• Support month‑end and year‑end close processes related to grant activity.

• Assist leadership and program teams in developing proposal budgets and budget narratives.
• Build detailed personnel cost models including fringe, allocation methodology, and funding splits.
• Support re‑budgeting requests and financial modifications as grant scopes evolve.
• Provide ongoing projections and spending forecasts to program and finance leadership.

• Prepare and submit grant invoices, reimbursement requests, and federal/state drawdowns.
• Maintain schedules of receivables and follow up on outstanding payments.
• Record grant revenue in accordance with nonprofit accounting standards and organizational policy.
• Ensure documentation supports all billed expenditures.

• Review subrecipient invoices and financial reports for compliance with contract terms and approved budgets.
• Ensure required documentation, supporting detail, and allowable cost standards are met prior to payment.
• Track subrecipient spending, reporting deadlines, and contract limits.
• Assist with risk assessment, monitoring documentation, and audit support for subawards.

• Interpret grant agreements, notice of award terms, and reporting requirements.
• Maintain organized financial documentation for all grants to support internal and external audits.
• Prepare audit schedules and supporting documentation for annual financial audit and grant‑specific reviews.
• Support implementation of strong internal controls related to restricted funding.

• Serve as a financial advisor to program managers and department leaders.
• Provide guidance on allowable expenses, documentation requirements, and spending timelines.
• Translate financial data into clear, actionable updates for non‑finance staff.
• Partner with finance leadership on strategic planning related to funded programs.

Reports to: Director of Grants Management/CFO

Classification: Full‑Time, Exempt

Work Location: Onsite / Hybrid

This role is considered mission‑critical to ensuring financial sustainability and regulatory compliance for grant‑funded healthcare programs serving vulnerable populations.

• Bachelor's degree in Accounting, Finance, or related field.
• Minimum 4‑7+ years accounting experience, including significant grant accounting responsibility.
• Experience working in nonprofit healthcare, FQHC, hospital system, or similarly regulated environment.
• Strong knowledge of fund accounting and restricted revenue tracking.
• Advanced Excel skills (budget modeling, pivot tables, reconciliation analysis).
• Demonstrated ability to manage multiple complex funding sources simultaneously.

• Experience managing federal healthcare or large multi‑program grant portfolios.
• Experience with subrecipient monitoring and compliance review.
• Familiarity with Uniform Guidance cost principles and grant compliance frameworks.
• Experience with nonprofit ERP/accounting systems.

The strongest candidates for this role will demonstrate:

• Ability to independently manage a complex grant portfolio with minimal supervision.
• Strong judgment in evaluating allowable vs. questionable expenses.
• Comfort working directly with clinical leadership and executive teams.
• Proactive communication style - identifies issues early and proposes solutions.
• High ownership mindset with strong documentation discipline.
• Ability to balance compliance rigor with operational practicality in a healthcare setting.