Controller

Job Announcement: Controller – Hamilton Healthcare System

About Our Healthcare System

Hamilton General Hospital, the flagship facility of Hamilton Healthcare System, is a 25-bed licensed Critical Access Hospital recognized as a Chartis Top 100 Critical Access Hospital in the U.S. Serving a multi-county region in Central Texas, our integrated health system encompasses:

• Emergency & Trauma: 24/7 Level IV Trauma Emergency Department supported by a regional EMS system operating 10 Mobile Intensive Care Units (MICUs) across 5 counties.
• Surgical Services: Outpatient and inpatient surgical capabilities including general, orthopedic, and interventional pain management procedures.
• Advanced Diagnostics & Laboratory: 24/7 Radiology (CT scan, digital mammography, MRI, X-ray) and a certified, full-service laboratory processing over 1 million tests annually.
• Specialized Programs: One of the few AACVPR-certified Cardiac & Pulmonary Rehabilitation programs in rural Central Texas, Diabetes Education, and Chronic Care Management.
• Outpatient & Primary Care Network: 3 Rural Health Clinics and multiple specialty outpatient clinics spanning three Central Texas communities.

Learn more about our mission and award-winning services at HamiltonHospital.org.

About Our Community

Located in the heart of Central Texas, Hamilton offers an affordable, safe, and close-knit small-town lifestyle with convenient proximity to major urban hubs (approx. 1 hour from Waco, 2 hours from Austin, and 2 hours from Fort Worth).

• Education: Served by Hamilton Independent School District, a highly rated district (A- overall rating on Niche, ranking in the top 20% of public-school districts in Texas) enrolling ~820 students across grades PK–12 with an exceptional 12:1 student-to-teacher ratio.
• Housing & Cost of Living: Outstanding affordability, with recent regional housing data placing median home values between substantially below state and national averages.
• Lifestyle: Zero traffic congestion, friendly neighbors, rich Texas Hill Country scenery, and an active rural lifestyle.

Position Overview

Title: Controller

Facility: Hamilton General Hospital / Hamilton Healthcare System

Location: Hamilton, Texas

Reports To: Chief Financial Officer (CFO)

Summary

The Controller directs the daily financial operations of Hamilton Healthcare System, ensuring high accuracy, regulatory compliance, and fiscal integrity across accounting, financial reporting, budgeting, payroll, and internal control systems. Working in direct partnership with the CFO and executive team, the Controller provides actionable financial intelligence, reimbursement analysis, and operational decision support to maintain long-term financial sustainability for our community-owned healthcare district.

Key Responsibilities

• Financial Operations & Reporting: Oversee general ledger maintenance, month-end and year-end financial closes, audited financial statement preparation, and general accounting reconciliations.
• Operational Accounting & Controls: Direct payroll processing, accounts payable (A/P), accounts receivable oversight, and internal financial audit controls.
• Budgeting & Strategic Analysis: Assist leadership with annual operational budgets, capital allocation plans, multi-year financial modeling, and departmental cost analyses.
• Reimbursement & Compliance: Maintain compliance with state and federal healthcare accounting standards, Medicare/Medicaid Critical Access Hospital cost-reporting rules, and Texas supplemental reimbursement models (such as QIPP).
• Team Leadership: Supervise, train, and mentor finance office personnel, fostering an organizational culture focused on precision, accountability, and efficiency.

Position Qualifications

Required

• Education: Bachelor’s degree in Accounting or Finance.
• Experience: Minimum of 3 years of progressive financial leadership experience within healthcare finance.
• Leadership: Proven supervisory or department management experience.

Preferred

• Certifications: Certified Public Accountant (CPA) designation strongly preferred.
• Advanced Degree: Master’s degree in Accounting, Finance, or Business Administration (MBA/MS).
• Healthcare Specialty: Direct experience in Critical Access Hospital (CAH) finance, CAH cost-reporting mechanics, and rural reimbursement structures.
• Texas Programs: Practical experience with the Texas Quality Incentive Payment Program (QIPP).

Work Location: In person