Director, RCM Revenue and Reserve Accounting

McKesson; Irving (TX); On-site; USD 132,000 - 219,000; Full time

Job summary

McKesson is seeking a Director of RCM Revenue and Reserve Accounting to provide strategic and hands-on leadership for reserve and discount processes across The US Oncology Network. You will own SOX controls, lead a dedicated team, and partner with Practice Finance and Controllership to translate reserve mechanics into actionable business decisions.

The role requires 12+ years of progressive accounting/finance experience and a strong track record in financial planning, forecasting, and executive

Qualifications

• Degree and typically requires 12+ years of professional experience and 4+ years of management experience.
• Experience in planning, forecasting, performance reporting, financial modeling, and executive decision support.
• Experience partnering with senior leaders across multiple functions.

Responsibilities

• Lead and develop the RCM Revenue and Reserve Accounting team, prioritizing recurring close responsibilities and SOX compliance.
• Own SOX controls documentation, execution, evidence, issue resolution and remediation.
• Partner with Practice Finance, Controllership, and Finance Systems to investigate variances and provide actionable insights.
• Drive scalable tools, reporting, and standard operating procedures for reserve performance.

Skills

Executive communication

People leadership

Cross-functional partnership

Strategic finance

SOX controls ownership

Data-driven analysis

Business partnering

Financial modeling

Education

Bachelor’s degree in Finance, Accounting, Business, Economics

MBA, CPA, CMA or related credential preferred

Tools

Excel

PowerPoint

Power BI

Tableau

Essbase

SAP

Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

Role Overview

The Director, RCM Revenue and Reserve Accounting provides strategic and hands‑on financial leadership for The US Oncology Network’s practice discount and accounts receivable reserve processes. Reporting to the Senior Director, Revenue Cycle Management Finance, this role serves as the senior Accounting subject matter expert for iReserve methodology, contractual allowances, bad debt, denials, AR aging, reserve governance, and the resulting balance sheet and income statement impacts for the practices. The Director leads review and interpretation of reserve performance across practices, resolves complex or nonstandard financial questions, and establishes consistent, supportable processes and controls. The Director partners closely with Practice Finance, Accounting, Controllership, Revenue Cycle Operations, Finance Systems, and data and analytics teams to investigate material variances, translate reserve mechanics into clear business implications, and recommend appropriate financial action. The role combines meaningful direct execution with team leadership, including ownership of SOX controls, prioritization of recurring close and practice‑support activities, development of scalable tools and documentation, and coaching of the RCM Revenue and Reserve Accounting team.

Key Responsibilities

Subject Matter Expertise for Practice Discount Reserve Processes

Serve as the senior subject matter expert for practice discount and patient AR reserve processes, including iReserve methodology, contractual allowances, bad debt, denials, AR aging, and the resulting balance sheet and income statement impacts; provide guidance on complex or unusual reserve matters and translate reserve mechanics into clear financial implications for practice and Network leadership Lead review and interpretation of reserve results across practices, including balance sheet-to-iReserve comparisons, historical and current discount-rate trends, AR aging, manual accruals and other drivers of reserve variability; identify outliers and coordinate root‑cause analysis and appropriate financial treatment Establish and continuously improve reserve methodologies, monitoring, and governance for revenue cycle processes.

Business Partnership with Practice Finance Teams

Serve as a strategic partner to Practice Controllers, Regional Finance Directors, practice leadership, and Revenue Cycle stakeholders, helping teams understand reserve and discount performance, investigate material variances, and determine appropriate actions when financial results diverge from expectations. Lead practice‑level financial discussions on AR and reserve matters, translating complex reserve methodology, collectability assessments, AR aging, and alternative financial treatments into clear implications for practice economics and decision‑making. Partner cross‑functionally with Practice Finance, Accounting, Revenue Cycle, Controllership, and data and technology teams to investigate issues, align financial and operational information, and develop supportable recommendations that balance accounting requirements with the underlying operations.

Sarbanes‑Oxley Control Ownership

Own and oversee RCM Finance SOX controls associated with patient AR reserves and financial discount processes, including control documentation, execution, evidence, issue identification, and remediation; ensure processes remain supportable as business requirements, systems, and reserve methodologies evolve. Maintain disciplined documentation and review standards around system flows and reserve calculations. Partner with Accounting, Controllership, Finance Systems, Internal Audit, and other stakeholders to identify control risks arising from changes in reserve logic, data flows, mappings or manual processes and drive sustainable processes.

Team Management and Prioritization

Lead and develop the RCM Revenue and Reserve Accounting team, establishing priorities, accountability, review standards, and a scalable operating model while building broader subject‑matter expertise across iReserve, discount reserves, controls, and practice support. Direct and prioritize team resources across recurring close responsibilities, practice support, troubleshooting, SOX requirements, and emerging financial issues, ensuring material matters receive timely analysis, escalation, and resolution. Build team capability through coaching, knowledge sharing, standardization, and development of repeatable analytical and operating processes to scale consistent support across the Network.

Other Ad Hoc Project Work

Lead or support RCM projects requiring reserve, accounting, or financial subject‑matter expertise, including practice‑specific and network‑wide scenarios. Develop improved tools, reporting, documentation, and processes that strengthen visibility into reserve performance and enable more proactive management of emerging risks across practices and the Network.

Minimum Requirements

Degree and typically requires 12+ years of professional experience and 4+ years of management experience.

Education

Bachelor’s degree in Finance, Accounting, Business, Economics, or a related field, or equivalent related experience. MBA, CPA, CMA, or other relevant advanced credential preferred.

Critical Skills

• Typically 12+ years of progressive Accounting, Finance, FP&A, or related analytical experience, including 4+ years of management responsibility.
• Demonstrated experience leading planning, forecasting, performance reporting, financial modeling, and executive decision support in a complex organization.
• Experience partnering with senior business and finance / accounting leaders across multiple functions and influencing outcomes without relying solely on formal authority.
• Experience with healthcare services, revenue cycle management, provider economics, accounts receivable, revenue and reserve analytics, or practice finance strongly preferred.

Additional Skills

• Financial and accounting acumen related to income statement, balance sheet, and Accounts Receivable and related reserve processes.
• Advanced analytical skill with the ability to investigate complex reserve and discount‑rate variances, connect source‑system activity to financial results, and develop supportable recommendations.
• Strong understanding of financial controls, process governance, documentation, and audit‑ready support, including ownership of SOX control execution and remediation.
• Strategic and analytical thinking combined with the ability and willingness to work directly in detailed data, financial models, reporting tools and executive materials.
• Executive communication and presence, including the ability to explain complex financial topics to practice and Network leaders.
• People leadership, coaching, prioritization, delegation, and talent development.
• Cross‑functional partnership, change leadership, conflict resolution, and stakeholder alignment.
• Digital fluency and a continuous‑improvement mindset, including scalable reporting, dashboarding, automation, and responsible use of technology.
• Strong judgment, attention to detail, ownership, adaptability, and comfort operating through ambiguity.

Systems and Tools

• Advanced Microsoft Excel and PowerPoint skills required.
• Experience with enterprise planning, ERP, business intelligence, and data platforms such as Essbase, SAP, Power BI, Tableau, or comparable tools preferred.

Salary and Compensation

Salary: 131,600.00 - 175,400.00 - 219,300.00 USD Annual with 20% MIP Target comp approx. 165-175K M4. This role is a hybrid position. The selected candidate is expected to work on-site at our Las Colinas office a minimum of two (2) days per week, with the remaining days worked remotely. Specific in-office days may be designated based on team needs and business priorities. We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards, determined by performance, experience and skills, equity, regular job‑market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long‑term incentive opportunities may be offered. Our Base Pay Range for this position $131,600 - $219,300.

Equal Opportunity Employer

McKesson is an Equal Opportunity Employer. McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category.

For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page. McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) [e-mail] or (Canada) [e-mail].