Fractional CFO / Controller

Fractional CFO / Controller

The Role

We are seeking an experienced finance partner to serve in a hybrid Fractional CFO / Controller capacity. This role spans both day-to-day accounting operations and strategic financial leadership. The right candidate is either a senior individual with demonstrated range across both functions, or a small firm where controller-level staff handle execution and a CFO-level principal provides strategic partnership.

Scope of Work

Controller / Operational Accounting

• Full-cycle AP/AR and invoice management
• Payment tracking and vendor reconciliation
• Payroll reconciliation
• Monthly close and financial statement preparation
• Balance sheet and P&L development
• Monthly internal reporting development
• Ramp platform administration: invoices, reimbursements, and expense tracking
• New bank account setup
• Coordination with external tax preparer
• Optional: equity issuance tracking and cap table reporting support

CFO / Strategic Finance

• PC/MSO structure fluency—understanding how revenue flows between MSO and PC entities and accounting for it correctly
• Financial forecasting and cash flow modeling
• Scenario planning and runway analysis
• Investor-ready reporting and board-level financial narrative
• Ongoing reporting to Roivant Sciences per the cadence below

Roivant Reporting Requirements

A core component of this engagement is timely, accurate reporting to Roivant Sciences. Candidates should review the following requirements carefully before expressing interest.

Monthly — due by business day 5:

• Balance sheet and income statement with flux explanations for line item changes >10%
• Capitalization table
• Cash and balance sheet reconciliations
• Cash runway analysis (forward-looking: timing and amount of next capital need)
• Revenue breakdown by customer, including revenue recognition methodology and any new or modified contracts

Quarterly — due by business day 7:

• Completed Roivant questionnaire addressing: fundraise status, leases, non-routine transactions, new bank accounts, litigation/settlements, 409A updates, unique equity grants, intercompany transactions, and any SOX issues or findings
• Summary of quarterly highlights

Adherence to these deadlines and responsiveness to follow-up questions from Roivant are essential requirements of this role.

Qualifications

Required:

• Experience supporting companies operating under a PC/MSO structure
• Prior work with venture-backed or early-stage companies, ideally at seed or Series A
• Hands-on controller experience—direct ownership of the monthly close, not oversight only
• Familiarity with investor or parent-company reporting requirements
• Proficiency with Ramp or comparable spend management platforms
• Familiarity with QuickBooks
• Experience with Insperity (PEO) payroll reconciliation, or ability to demonstrate a clear onboarding path

Preferred:

• Background in digital health, healthcare services, or managed care
• Experience supporting 409A processes and cap table management
• Prior experience establishing banking infrastructure across multiple healthcare entities

We welcome inquiries from both individual fractional practitioners and small advisory firms with relevant healthcare finance experience.

Work Arrangement: Remote (any location)

Employment Type: Contract