Head of Finance

About Us

1 in 25 adolescents will be diagnosed with serious mental illness. Most don’t get the care they need. Flourish (https://flourish.health/) is solving that.

About the Role

We have the beginnings of a finance function. It works, but it’s early. You will make it great.

This is not a “manage the function” role. This is a take what exists and level it up fast role—while helping us make better decisions every day.

You will report directly to the CEO and partner with the leadership team to bring rigor to how we plan, spend, and grow. You should be comfortable going from messy data → clear insight → real decisions.

You will bring operational and strategic excellence to our billing operations, which is critical to the company’s success. This includes leading timely collections, strong payer operations, identifying opportunities to improve revenue cycle performance, and clear reporting to c-suite.

What You’ll Do:

• Be the financial voice in the room
  Challenge decisions. Pressure-test plans. Help us see risks and tradeoffs we’re currently missing.

• Own planning and forecasting
  Build and refine the models that drive how we hire, invest, and grow. Run scenarios so we can see around corners.

• Turn numbers into decisions
  Our data exists, but we don’t fully use it. You’ll fix that—turning metrics into clear recommendations.

• Level up the finance function
  Improve what’s already in place across FP&A, accounting, and reporting. Create real visibility into burn, runway, and unit economics.

• Own billing operations (critical)
  Billing is core to how this business works. You will own billing, collections, and payer operations end-to-end—driving both operational excellence and strategic improvement in how we get paid.

• Partner closely with GTM
  Help us understand growth efficiency, state expansion tradeoffs, and how to scale revenue without harming safe patient care.

• Lead tax process
  Own and manage the tax process across our MSO/PC structure, working with external partners to ensure compliance while optimizing for efficiency as we scale.

• Bring discipline to how we operate
  We want to move fast, but not blindly. You’ll help us stay ambitious and grounded in reality.

What This Role Is (and Isn’t)

This role is:

• Hands-on

• Ambiguous

• Strategic + operational at the same time

• About building and improving

This role is not:

• A large team

• Pure accounting or reporting

• A fully built, clean system you’re stepping into

• Maintaining a function

Role Requirements:

• Has served in a senior finance or strategy leadership role at a startup or high-growth environment

• 10+ years of experience in finance, strategy, investment banking, private equity, or operating roles

• Experience building financial models and operating financial systems from the ground up

• Strong understanding of accounting fundamentals, especially with MSO/PC corporate structure

• Experience with revenue operations (healthcare experience is a plus)

• Demonstrated ability to operate both strategically and at a detailed execution level

• Experience managing or partnering with external finance resources (e.g., fractional CFO, auditors, firms)

• Experience with NetSuite, Bill.com, Carta and Excel.

• Prior people management experience preferred

The Right Person

The right person (you!) cares deeply about building a sustainable, high-quality company that improves outcomes for adolescents with serious mental health conditions. You are both rigorous and pragmatic, and you enjoy being the person who brings clarity to complex problems.

If that resonates, we encourage you to apply—even if you don’t check every box. We’re focused on building a team that can grow together.

We strongly encourage individuals from underrepresented communities to apply, including people of color, LGBTQ-identifying individuals, veterans, and differently abled individuals.

Job Type: Full-Time

Work location: Re