Strategic Finance Lead Jobs in USA with Visa Sponsorship
Strategic Finance Leads typically qualify for H-1B visa or O-1 visa sponsorship, as the role requires a bachelor's degree or higher in finance, economics, or accounting, meeting the specialty occupation standard. Employers in tech, private equity, and high-growth startups sponsor this title regularly. For detailed occupation requirements, see the O*NET profile.
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Here at Ambience, we never set out to be just another scribe. We’re building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country. Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work. Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America. Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners. We value candor, positivity and deep thought — and we expect a lot from each other because we know the problems we’re solving truly matter. Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025. We’re backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins — and we’re just getting started.
Summary
Ambience is looking for a Strategic Finance / FP&A Lead to own and scale the company's financial forecasting, planning, and reporting infrastructure. In this role, you will build and maintain the financial models that drive high-confidence decision-making across GTM, Product, and Executive leadership. You will bring discipline to top-line modeling, support investor and board storytelling, and partner with accounting to ensure forecasting practices are GAAP- and audit-ready. This is not a back-office finance role. You will be embedded in the business, working directly with sales, product, and operations leaders to translate operational reality into forward-looking financial visibility. The right person combines deep SaaS finance fluency with the ability to operate independently in a fast-moving, high-growth environment.
What you will accomplish
- Fully own and maintain Ambience's 2-year financial model and rolling P&L forecast, including version control, updates, and internal distribution.
- Lead the annual planning process end-to-end, including bottoms-up budgeting, goal alignment with department leads, and integration into the operating model.
- Establish and run a monthly reporting cadence for forecast vs. actuals, including budget variance analysis, cash forecasting, and key variance commentary.
- Lead financial preparation for quarterly board meetings, including top-line forecast updates, performance narratives, and investor-ready materials.
- Build forecasting engines that link rep capacity, pipeline stages, and pricing into revenue forecasting, partnering with GTM and RevOps to validate assumptions.
- Represent finance at deal desk to ensure effective margin representation across customer engagements.
Early success indicators (first 3 to 6 months)
- Full ownership of the financial model and monthly forecast is transitioned, with a clear cadence for updates and scenario modeling.
- Monthly reporting for forecast vs. actuals is stood up and running within 3-5 business days of close, with variance commentary that surfaces operational drivers.
- A bottoms-up budgeting process is launched and underway with department leads, rolling into the operating model.
- Financial preparation for board materials is delivered on time, with polished and exec-ready outputs that translate complex models into clean insights.
- Pipeline-to-revenue forecasting models are operationalized, improving accuracy of long-range CARR forecasts.
What We Look For (must-have Qualifications)
- 6-10 years in strategic finance, FP&A, or investment banking with progression into operating roles at high-growth SaaS or technology companies.
- Direct experience owning company-wide financial models and annual planning processes, including multi-year P&L forecasting and scenario analysis.
- Strong fluency in SaaS metrics, cohort-based revenue modeling, and enterprise sales finance (pipeline conversion, rep productivity, CARR/ARR).
- Demonstrated ability to partner cross-functionally with GTM, Product, and G&A leaders to align financial planning with business strategy.
- Excellent executive communication: translates complex financial models into crisp, defensible insights for leadership and board audiences.
- High ownership mentality: independently manages forecast updates, builds repeatable processes, and drives automation without hand-holding.
Nice-to-have Qualifications
- Healthcare or other regulated industry experience.
- Experience partnering closely with Accounting on GAAP revenue recognition, close processes, and audit readiness.
- Familiarity with modern planning and BI tools such as Adaptive, Pigment, Sigma, or similar.
- Experience supporting fundraising processes or investor relations at a venture-backed company.
- Background in management consulting or investment banking prior to operating roles.
Pay Transparency
The base compensation for this role is approximately $190,000 to $225,000 per year, excluding equity or bonus targets. The range is intentionally broad to allow candidates flexibility in choosing the cash and equity mix that fits their needs. We place strong emphasis on meaningful equity grants so that contributors share directly in the value they help create. If your expectations fall outside of this range, we still encourage you to apply. We tailor compensation for each candidate based on the factors most relevant to their situation.
Life at Ambience
Working at Ambience means opting into a high-ownership, high-trust environment built for people who want to grow fast, operate decisively and focus on work that matters. This could be the right place for you if you want to
- Work on mission-critical AI technology that directly improves clinicians’ day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world.
- Join a “dream team” culture where we hire exceptional people, expect exceptional outcomes and invest deeply in feedback and continuous growth. We operate as a championship team, and that means being ok with hard, uncomfortable, ambiguous problems that lead to real greatness.
- Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion.
To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond. Some of our key benefits include
- Comprehensive medical, dental, and vision coverage for you and your dependents
- 401(k) with a company match of up to 3% of base salary
- A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you’re based.
- Parental leave to support your family needs
- Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered
- Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24–January 1 designed to support real rest and long-term sustainability.
Ambience Healthcare is an equal opportunity employer and is committed to building a diverse and inclusive workplace. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, genetic information, or any other legally protected status. We encourage applicants from all backgrounds to apply.
Ambience is committed to supporting every candidate’s ability to fully participate in our hiring process. If you need any accommodations during your application or interviews, please reach out to our Recruiting team at accommodations@ambiencehealthcare.com. We’ll handle your request confidentially and work with you to ensure an accessible and equitable experience for all candidates.
Ambience Healthcare has become aware of scams targeting jobseekers with fake jobs and even interviewing people. Our emails will always come from @ambiencehealthcare.com. We would never ask candidates to download apps or make any form of payment(s). If you are contacted through WhatsApp, Telegram, similar but fake email domains, or asked to make a payment, these contacts are not legitimate. Report the issue immediately to LinkedIn and the FBI.
About us
Here at Ambience, we never set out to be just another scribe. We’re building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country. Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work. Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America. Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners. We value candor, positivity and deep thought — and we expect a lot from each other because we know the problems we’re solving truly matter. Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025. We’re backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins — and we’re just getting started.
Summary
Ambience is looking for a Strategic Finance / FP&A Lead to own and scale the company's financial forecasting, planning, and reporting infrastructure. In this role, you will build and maintain the financial models that drive high-confidence decision-making across GTM, Product, and Executive leadership. You will bring discipline to top-line modeling, support investor and board storytelling, and partner with accounting to ensure forecasting practices are GAAP- and audit-ready. This is not a back-office finance role. You will be embedded in the business, working directly with sales, product, and operations leaders to translate operational reality into forward-looking financial visibility. The right person combines deep SaaS finance fluency with the ability to operate independently in a fast-moving, high-growth environment.
What you will accomplish
- Fully own and maintain Ambience's 2-year financial model and rolling P&L forecast, including version control, updates, and internal distribution.
- Lead the annual planning process end-to-end, including bottoms-up budgeting, goal alignment with department leads, and integration into the operating model.
- Establish and run a monthly reporting cadence for forecast vs. actuals, including budget variance analysis, cash forecasting, and key variance commentary.
- Lead financial preparation for quarterly board meetings, including top-line forecast updates, performance narratives, and investor-ready materials.
- Build forecasting engines that link rep capacity, pipeline stages, and pricing into revenue forecasting, partnering with GTM and RevOps to validate assumptions.
- Represent finance at deal desk to ensure effective margin representation across customer engagements.
Early success indicators (first 3 to 6 months)
- Full ownership of the financial model and monthly forecast is transitioned, with a clear cadence for updates and scenario modeling.
- Monthly reporting for forecast vs. actuals is stood up and running within 3-5 business days of close, with variance commentary that surfaces operational drivers.
- A bottoms-up budgeting process is launched and underway with department leads, rolling into the operating model.
- Financial preparation for board materials is delivered on time, with polished and exec-ready outputs that translate complex models into clean insights.
- Pipeline-to-revenue forecasting models are operationalized, improving accuracy of long-range CARR forecasts.
What We Look For (must-have Qualifications)
- 6-10 years in strategic finance, FP&A, or investment banking with progression into operating roles at high-growth SaaS or technology companies.
- Direct experience owning company-wide financial models and annual planning processes, including multi-year P&L forecasting and scenario analysis.
- Strong fluency in SaaS metrics, cohort-based revenue modeling, and enterprise sales finance (pipeline conversion, rep productivity, CARR/ARR).
- Demonstrated ability to partner cross-functionally with GTM, Product, and G&A leaders to align financial planning with business strategy.
- Excellent executive communication: translates complex financial models into crisp, defensible insights for leadership and board audiences.
- High ownership mentality: independently manages forecast updates, builds repeatable processes, and drives automation without hand-holding.
Nice-to-have Qualifications
- Healthcare or other regulated industry experience.
- Experience partnering closely with Accounting on GAAP revenue recognition, close processes, and audit readiness.
- Familiarity with modern planning and BI tools such as Adaptive, Pigment, Sigma, or similar.
- Experience supporting fundraising processes or investor relations at a venture-backed company.
- Background in management consulting or investment banking prior to operating roles.
Pay Transparency
The base compensation for this role is approximately $190,000 to $225,000 per year, excluding equity or bonus targets. The range is intentionally broad to allow candidates flexibility in choosing the cash and equity mix that fits their needs. We place strong emphasis on meaningful equity grants so that contributors share directly in the value they help create. If your expectations fall outside of this range, we still encourage you to apply. We tailor compensation for each candidate based on the factors most relevant to their situation.
Life at Ambience
Working at Ambience means opting into a high-ownership, high-trust environment built for people who want to grow fast, operate decisively and focus on work that matters. This could be the right place for you if you want to
- Work on mission-critical AI technology that directly improves clinicians’ day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world.
- Join a “dream team” culture where we hire exceptional people, expect exceptional outcomes and invest deeply in feedback and continuous growth. We operate as a championship team, and that means being ok with hard, uncomfortable, ambiguous problems that lead to real greatness.
- Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion.
To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond. Some of our key benefits include
- Comprehensive medical, dental, and vision coverage for you and your dependents
- 401(k) with a company match of up to 3% of base salary
- A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you’re based.
- Parental leave to support your family needs
- Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered
- Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24–January 1 designed to support real rest and long-term sustainability.
Ambience Healthcare is an equal opportunity employer and is committed to building a diverse and inclusive workplace. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, genetic information, or any other legally protected status. We encourage applicants from all backgrounds to apply.
Ambience is committed to supporting every candidate’s ability to fully participate in our hiring process. If you need any accommodations during your application or interviews, please reach out to our Recruiting team at accommodations@ambiencehealthcare.com. We’ll handle your request confidentially and work with you to ensure an accessible and equitable experience for all candidates.
Ambience Healthcare has become aware of scams targeting jobseekers with fake jobs and even interviewing people. Our emails will always come from @ambiencehealthcare.com. We would never ask candidates to download apps or make any form of payment(s). If you are contacted through WhatsApp, Telegram, similar but fake email domains, or asked to make a payment, these contacts are not legitimate. Report the issue immediately to LinkedIn and the FBI.
See all 4,089+ Strategic Finance Lead Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Strategic Finance Lead roles.
Get Access To All JobsTips for Finding Strategic Finance Lead Jobs
Target employers who have filed LCAs for finance roles
Companies that have previously sponsored financial analysts, FP&A managers, or finance directors are far more likely to sponsor a Strategic Finance Lead. Look for employers with a documented history of H-1B filings in finance functions, not just engineering.
Align your degree field directly to the role
H-1B approval for this title depends on demonstrating a direct connection between your degree and the job. Finance, economics, accounting, or business analytics degrees map cleanly. A general business degree with no finance specialization can create friction at USCIS.
Emphasize FP&A, modeling, and strategic planning experience
Sponsoring employers need to justify the specialty occupation requirement. Resumes that highlight financial modeling, scenario analysis, and cross-functional planning signal the specialized knowledge USCIS requires, making the petition stronger and faster to approve.
High-growth startups and tech companies sponsor most frequently
Series B and later-stage startups, SaaS companies, and fintech firms hire Strategic Finance Leads at high volume and have established immigration counsel on retainer. These employers are more accustomed to sponsorship and less likely to treat it as an obstacle.
Request premium processing if your OPT or status is time-sensitive
Standard H-1B processing can take several months. Premium processing guarantees a decision within 15 business days for an additional fee. If your OPT expiration or 60-day grace period is approaching, raise this with your employer before filing.
Prepare for possible RFEs on specialty occupation
USCIS occasionally issues Requests for Evidence on finance roles, questioning whether the position truly requires a specialized degree. Having a detailed job description, organizational chart, and degree equivalency letter ready in advance significantly reduces response time.
Frequently Asked Questions
Does a Strategic Finance Lead role qualify as a specialty occupation for H-1B purposes?
Yes, in most cases. USCIS evaluates whether the position normally requires at least a bachelor's degree in a specific field. Strategic Finance Lead roles that involve financial modeling, forecasting, and capital allocation analysis typically satisfy this standard, particularly when the job description specifies a degree in finance, economics, or accounting as a minimum requirement rather than a preference.
Which visa types are most commonly used to sponsor Strategic Finance Leads?
H-1B visa is the most common path. Australians can also pursue the E-3 visa, which has no lottery and is significantly easier to obtain. Canadians and Mexicans may qualify under TN visa status using the Economist or Accountant categories, depending on the role's responsibilities. Exceptional candidates with a strong track record in finance leadership may also explore the O-1A for individuals with extraordinary ability.
How can I find Strategic Finance Lead jobs that offer visa sponsorship?
Migrate Mate is built specifically for this, it surfaces roles from employers actively willing to sponsor work visas, filtered by job title and visa type. Most general job boards don't filter by sponsorship status, so you end up applying to roles that won't move forward. Migrate Mate removes that friction and focuses your search on employers already open to sponsoring.
Will my degree field affect H-1B approval for this role?
Directly, yes. The H-1B specialty occupation standard requires a theoretical and practical application of highly specialized knowledge, which USCIS ties to your degree field. Finance, economics, accounting, and business analytics degrees align well with Strategic Finance Lead duties. A degree in an unrelated field, even a technical one, may require additional documentation or a credential evaluation to establish relevance.
What happens if USCIS issues an RFE on my Strategic Finance Lead H-1B petition?
An RFE for a finance role most commonly questions whether the position requires a specialized degree or whether your degree matches the role. Your employer's immigration attorney will draft a response with supporting evidence, a detailed job description, organizational chart, expert opinion letters, and your academic credentials. Response timelines are typically 60 to 87 days. Most well-documented petitions survive RFEs without denial.
What is the prevailing wage requirement for sponsored Strategic Finance Lead jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.