Books, Benchmarks, and Beyond: Building Finance Foundations in a Scaling Startup

The Client

Our client is a rapidly growing healthcare tech startup in the Bay Area backed by a leading private equity firm with over $2.7 billion invested across 44 portfolio companies. The firm operates with a thesis-driven strategy rooted in identifying long-term healthcare trends and partnering with world-class executives to build, scale, and optimize businesses. Their approach leverages a Center of Excellence and a network of Executives in Residence, bringing deep industry expertise and operational excellence to their portfolio companies.

The Mandate

In the midst of rapid scaling and ongoing leadership transitions, the client needed to urgently stabilize their finance function. The company’s books were significantly behind, and audit readiness was a top priority due to impending SEC filings and increased scrutiny from investors.

While in the process of hiring a permanent CFO, the client engaged an Interim Controller who could immediately step in to clean up prior-year financials, establish baseline accounting controls, and implement the foundational reporting infrastructure needed for audit and growth readiness. This role also required working cross-functionally with operations and executive leadership to ensure alignment between financial systems and business needs in a startup environment.

The ideal candidate needed to be comfortable working hands-on in an unstructured environment, with the strategic acumen to anticipate and prevent future bottlenecks while creating repeatable and scalable finance processes.

The Search

The ideal candidate needed a strong public accounting foundation (Big 4), CPA credentials, and extensive experience in financial operations and process optimization—ideally in high-growth, venture-backed companies. Previous experience as an auditor and comfort operating in early-stage environments were key criteria.

The Placement

The chosen interim professional brought over 25 years of experience in finance leadership roles, including serving as a fractional CFO and VP of Finance for companies across biotech, SaaS, real estate, and diagnostics. A licensed CPA with an MBA from Kellogg, they had a strong foundation in audit and a track record of supporting rapid-growth environments.

Having scaled a healthcare diagnostics business from inception to $20M in revenue, the placement understood the complexities of regulated, high-growth companies and how to build finance operations that could flex with the business. Their broad experience in financial modeling, budgeting, and reporting was matched by their collaborative leadership style and ability to communicate financial matters clearly across both technical and non-technical stakeholders.

Crucially, they also brought a strategic mindset—balancing near-term accounting cleanup with long-term process design—and a willingness to roll up their sleeves to deliver results in a fast-moving, resource-constrained setting.

The Outcome

The interim placement quickly stabilized and professionalized the company’s financial operations. Within approximately five months, they:

• Successfully cleaned up the company’s financial books for prior fiscal years and prepared for audit in anticipation of upcoming SEC filings
• Partnered with internal staff and external consultants to build accurate, audit-ready financial statements
• Established scalable processes and internal controls across payroll, revenue recognition, and expense categorization
• Acted as a strategic partner to senior leadership, delivering financial insights that supported the company's growth goals
• Laid the groundwork for the incoming CFO, ensuring continuity and a clean handoff

Their work provided critical structure and credibility to the company’s finance function, enabling leadership to confidently move forward with investor communications, regulatory preparation, and long-term financial planning.