Finance Lead: First In-House, HealthTech Startup (Remote)

UpDoc; San Francisco (CA); On-site; USD 140,000 - 200,000; Full time

Job summary

UpDoc is seeking a hands-on Finance Lead to build the company’s financial infrastructure from the ground up while managing planning, budgeting, forecasting, grants, and revenue cycle operations. You’ll lead financial modeling, reporting, and partnerships with leadership to drive strategic decisions in a fast-growing healthcare tech startup.

As the first in-house finance hire, you’ll own core processes, ensure audit readiness, and scale systems across accounting, grants, and compliance, with a

Qualifications

• 6+ years of experience across strategic finance, FP&A, accounting, healthcare finance, or related roles in a startup or high-growth environment.
• Experience owning financial models, budgets, forecasts, and scenario planning.
• Strong understanding of financial statements and accounting fundamentals, with depth to oversee the close.
• Grant budgeting and financial management, including budgeting, tracking, reporting, compliance, and audit-ready docs.
• Strong understanding of healthcare revenue cycle management, including coding, billing, and reimbursement.
• Ability to translate financial and operational data into clear exec recommendations.
• Demonstrated ability to build processes and financial infrastructure from scratch.
• Proficiency with AI tools to improve finance, analysis, reporting, or workflows.
• Excellent analytical skills and attention to detail.
• Strong written and verbal communication for executive reporting.
• Independent, hands-on with operational and strategic work.
• Adaptable to a fast-moving, ambiguous early-stage environment.

Responsibilities

• Own UpDoc’s financial planning and analysis, including annual planning, budgeting, forecasting, and scenario modeling.
• Build and maintain the company’s financial model with visibility into revenue, expenses, cash, runway, and headcount.
• Own monthly and quarterly financial reporting and develop dashboards for performance.
• Partner with leadership on resource allocation, hiring plans, and strategic investments.
• Oversee the accounting function and external partners, ensuring timely month-end close and accurate statements.
• Manage core finance processes: accounts payable/receivable, expenses, purchasing, payroll, and cash.
• Own financial management of grants, including budgeting, forecasting, and reporting.
• Ensure grant compliance and audit readiness with internal and external advisors.
• Oversee revenue cycle management: coding, billing, claims, reimbursement, collections.
• Develop reporting and controls to monitor revenue cycle performance and improve efficiency.
• Coordinate tax, audit, insurance, and other compliance activities with external advisors.
• Support board and investor reporting with analyses and KPIs.
• Assist fundraising with modeling, diligence, and data-room prep.
• Help manage cap table and equity reporting with leadership and advisors.
• Develop financial and operational metrics to guide scale (revenue, margins, unit economics).
• Evaluate finance systems and workflows to improve accuracy and efficiency.
• Leverage AI to enhance finance analytics and reporting.
• Take ownership of finance-related and operational projects as needed.
• Foster financial discipline without unnecessary bureaucracy.
• Shape how the finance function evolves and scales with the company.

Skills

Strategic finance

FP&A

Accounting fundamentals

Grant budgeting

Revenue cycle management

Data-driven decisions

Executive communication

Independent ownership

AI in finance

Analytical thinking

Education

CPA or MBA

Tools

QuickBooks

NetSuite

Carta

Gusto

Ramp

Brex

Excel

Tableau

Job description

UpDoc is seeking a hands-on Finance Lead to build the company’s financial infrastructure from the ground up while managing planning, budgeting, forecasting, grants, and revenue cycle operations. You’ll lead financial modeling, reporting, and partnerships with leadership to drive strategic decisions in a fast-growing healthcare tech startup.

As the first in-house finance hire, you’ll own core processes, ensure audit readiness, and scale systems across accounting, grants, and compliance, with a