Assistant Director, Health Care Accounting & Financial Reporting

University of Iowa Health Care is the state’s only comprehensive academic medical center, bringing together world-class patient care, pioneering research, and outstanding education. As a nationally recognized leader in medicine, we offer opportunities to work alongside top experts in a collaborative, innovative environment that values excellence, compassion, and discovery. Join us in shaping the future of health care—while making a meaningful difference in the lives of patients and communities across Iowa and beyond.

UI Health Care has an opportunity for a skilled Assistant Director of Health Care Accounting & Financial Reporting to oversee the integration and technical accounting leadership of financial reporting and compliance function for University of Iowa Health Care’s multi-entity, multi-billion-dollar enterprise. This role ensures compliance with U.S. GAAP, GASB, and institutional financial policies while helping lead the month-end and year-end close processes, internal control structure, and financial reporting system developments and enhancements. The position collaborates with key stakeholders across the health care enterprise, the University of Iowa, and external stakeholders to support financial initiatives, optimize financial processes, and ensure the accuracy and integrity of the general ledger and financial reporting frameworks.  

Position Responsibilities:

Financial Oversight & General Ledger Management:

• With oversight from the Director of Accounting, directs the planning, organization, and structure of the general ledger (GL) to ensure proper financial reporting, compliance with U.S. GAAP and GASB, and seamless integration of new financial reporting entities.

• Leads financial integration efforts for acquisitions, expansions of new service lines, and transitions of service lines, ensuring alignment with institutional financial frameworks, while supporting downstream requirements for Medicare Cost Reporting (MCR), and 340B program eligibility.

• Ensures strong internal controls and segregation of duties by designing structured workflow approvals, analyzing financial feeder systems, and establishing clear expectations for financial operations to mitigate risk and enhance financial accuracy.

• Anticipates downstream financial reporting implications when structuring general ledger accounts, ensuring seamless integration with institutional fund flows, faculty compensation models, Medicare Cost Reporting, and consolidated financial statement preparation.

Financial Reporting: Month-End Close Leadership:

• With oversight from the Director of Accounting, facilitates the high-intensity 7-business-day month-end close process, ensuring timely reconciliation, journal entry approvals, and financial analysis across UI Health Care financial reporting entities.

• Serves as the primary reviewer and approver for journal entries, workpapers, reconciliations, and financial feeder systems, ensuring the accuracy and completeness of all financial activity recorded in the general ledger for non-patient related revenue sections of the financial statements.

• Ensures precise accruals and expense recognition for major cost categories, including salaries, variable compensation, contract labor, employee benefits (pension, OPEB, compensated absences), pharmaceuticals, medical supplies, professional service agreements, maintenance agreements, complex self-insured liability responsibilities, administrative costs, and internal overhead allocations.

• Directs the calculation and reporting of key financial metrics such as days cash on hand, debt-to-capital ratios, and financial performance benchmarks for executive leadership and credit rating agencies.

• Leads a team of financial analysts in preparing dashboards, variance analyses, and executive summaries to provide concise and actionable financial insights to senior leadership.

• Collaborates closely with direct and indirect teams across the University to ensure all income statement and balance sheet components are properly recorded and reported.

Year-End Close, Financial Statement Preparation, & Audit Coordination:

• Manages the year-end financial close and audit process, ensuring timely completion of external audits, bondholder disclosures, and government compliance filings.

• Serves as the primary reviewer for all non-patient revenue journal entries, reconciliations, and supporting workpapers, ensuring accuracy in financial reporting.

• Develops and implements elimination entry journal entries and inter-entity reconciliations for multiple reporting entities within UI Health Care.

• Leads the preparation of financial statement footnotes and audit disclosures, coordinating with external audit & actuarial teams, the Auditor of State, and finance & accounting leadership.

• Oversees the financial reporting for self-insured liabilities, working with actuaries to determine IBNR reserves, tail liabilities, and premium allocations for UI Physicians (UIP), UI Health Care, and Iowa Medical Mutual Insurance Company (IMMIC).

Technical Accounting Leadership & Policy Development:

• Leads GASB technical research and implementation, ensuring UI Health Care remains at the forefront of evolving accounting standards.

• Serves as the institutional lead on new GASB policies, providing guidance to finance leadership, university financial reporting, and operational finance teams.

• Partners with the senior leadership on strategic initiatives, including gift accounting policy modernization and optimizing institutional overhead applications.

• Establishes governance frameworks for financial reporting accuracy, regulatory compliance, and alignment with best practices in academic medical centers.

• Ensures compliance with tax-exempt financing regulations and private-use limitations, working closely with institutional financial leadership to structure transactions appropriately.

Financial Systems Development & Automation

• Leads financial reporting system enhancements, collaborating with UI Accounting & Financial Reporting, UI Business Services, and health care IT teams to develop automated financial dashboards and analytic tools.

• Serves as a key financial leader on committees focused on financial system development.

• Directs financial reporting modernization projects, ensuring efficiency, accuracy, and integration of real-time financial data.

• Works in collaboration with key stakeholders and leadership to ensure financial system enhancements align with long-term reporting needs.

Financial Leadership & Training

• Develops and implements enterprise-wide financial training programs, ensuring structured onboarding for finance staff, department administrators, and operational leaders.

• Serves as a mentor and subject matter expert for technical accounting, financial reporting, and compliance best practices.

• Leads structured onboarding and training pathways for newly acquired entities and expanding service lines.

• Provides direct mentorship and career development for both direct and indirect reports, ensuring financial analysts, accountants, and managers gain expertise in complex accounting, internal controls, and financial reporting.

• A Master’s degree in Accounting or an equivalent combination of education and experience is required

• Five years of progressive experience in accounting or financial management, including at least two years in a leadership role within a complex healthcare or academic medical center environment.

• 1-3 years of supervisor experience

• Strong understanding of U.S. GAAP, GASB, and financial reporting best practices.

• Experience with financial system integrations, acquisitions, and internal control frameworks.

• Strong leadership skills with a proven track record of mentoring and developing accounting professionals.

• Self-motivated with a passion for continuous learning and desire to take on tough and challenging projects.

• Superb time management skills and the ability to multi-task and work in a fast-paced environment.

• Strong attention to detail and demonstrated ability to perform complex financial analyses.

• Demonstrated ability to filter through ambiguity while executing on the details of tasks under tight deadlines.

• Demonstrated ability to work independently and in conjunction with cross-functional teams.

• Excellent written and verbal communication skills.

• Ability to think critically and creatively when working with data.

• Demonstrated proficiency with Microsoft software applications including Excel, PowerPoint, Outlook, and Word.

• Demonstrated experience working effectively in a welcoming and respectful workplace environment.

Desired

• Certified Public Accountant license.

• Master’s degree in Accounting, Finance, Business Administration, or a related field.

• 4 years of relevant healthcare accounting experience. Preference given to a background in an academic setting

• Demonstrated ability to transform data into useful information tailored to leadership needs through storytelling and data visualizations.

• Experience with relational databases, structured query language (SQL), Tableau, PowerBI

• Experience in identifying opportunities for operational improvement and using creative efforts to bring about solutions.

• Experience with financial reporting systems, ERP implementations, and automation initiatives.

• Knowledge of healthcare finance, Medicare Cost Reporting, and 340B compliance considerations.

Application Process: To be considered, applicants must upload a cover letter and resume (under the submission of relevant materials) that clearly address how they meet the listed required and desired qualifications of this position. Job openings are posted for a minimum of 7 calendar days. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification.

 Up to 5 professional references will be requested at a later step in the recruitment process. For questions, contact Sharon Walther at sharon-walther@uiowa.edu.

This position is not eligible for University sponsorship for employment authorization now or in the future.