6d ago

Head of Finance

United StatesUnited States·San Franciscofull-timeexecutive
Finance & AccountingFinance Manager
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Quick Summary

Overview

Midstream is an AI-native financial operating system for health systems, founded by experienced entrepreneurs and backed by top-tier investors. We give finance, supply chain,

Technical Tools
Finance & AccountingFinance Manager

We are looking for a Strategic Finance and Operations Lead to work directly with our CEO on some of the most consequential decisions we make as a company.

You will help build the financial and strategic infrastructure behind those decisions by developing a forward-looking view of the business, evaluating where we should invest, supporting capital strategy, and clarifying the tradeoffs behind our biggest bets.

You will also play a central role in how we work with our investors and Board, from preparing for Board discussions and investor updates to helping shape the story of where the company is going and what we need to accomplish next.

This is an opportunity for someone who has developed a strong financial and strategic foundation and wants to move closer to the outcome. We are looking for someone who is hungry for ownership, learns exceptionally quickly, and wants to help build the company rather than evaluate it from the outside.

You will take ownership of the analysis and thinking behind some of Midstream's most consequential decisions. You will turn ambiguous questions into clear choices, develop an independent point of view, and work with the CEO to move from recommendation to decision and outcome.

You will build and maintain the forward-looking view leadership uses to run the company across growth, revenue, headcount, expenses, burn, runway, and capital needs. You will connect the numbers to what is happening across the business, surface the assumptions and risks that matter, and ensure leadership understands how major decisions change our trajectory.

You will own the preparation and increasingly the management of key investor and Board interactions. You will develop clear, credible materials and communications, anticipate the questions sophisticated stakeholders will ask, and ensure our performance, strategy, and long-term opportunity come together in a coherent narrative.

You will help determine when and why Midstream should raise additional capital and what we should accomplish with it. You will connect operating choices to runway and future financing needs, shape fundraising strategy and projections, and keep the company prepared well before a financing process begins.

You will step into consequential problems that do not fit neatly within one function and take responsibility for moving them forward. You will build context quickly, work across Product, Engineering, Commercial, Operations, and other teams, challenge assumptions where needed, and stay with the work through execution and outcome.

You have a strong foundation in finance and understand how businesses and investments are evaluated.

You have likely spent several years in private equity, growth equity, venture capital, investment banking, strategic finance, or another highly analytical environment.

You move comfortably between detailed financial analysis and high-level company strategy.

You are intellectually curious and naturally ask why something works the way it does.

You reason from first principles rather than relying solely on established frameworks.

You are comfortable developing and defending a point of view with incomplete information.

You communicate clearly with senior stakeholders and know how to build trust over time.

You have high standards, low ego, and are comfortable challenging assumptions, including those of senior leaders.

You want significantly more ownership in your next role.

Most importantly, you want to build and own outcomes, not simply analyze or advise from the sidelines.

Location & Eligibility

Where is the job
San Francisco, United States
On-site at the office
Who can apply
US

Listing Details

Posted
September 30, 2026
First seen
September 30, 2026
Last seen
October 5, 2026

Posting Health

Days active
4
Repost count
0
Trust Level
34%
Scored at
October 5, 2026

Signal breakdown

freshnesssource trustcontent trustemployer trust
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Head of Finance