Business Services and Finance Manager

About Kids Operating Room

Kids Operating Room is a global health nonprofit that designs, equips, and installs solar-powered pediatric operating rooms in low-resource and conflict-affected regions. Working closely with Ministries of Health and hospitals, we strengthen surgical systems for children. With more than 100 operating rooms across 35 countries, we have enabled over 640,000 surgeries to date.

Role Summary

As the fifth member of our small U.S. team, the Business Services and Finance Manager ensures strong financial management, operational support, and regulatory compliance across Kids Operating Room USA. This cross-functional role spans finance, HR, governance, and business services, and plays a central role in ensuring organizational sustainability and effectiveness.

This role requires a proactive, mission-aligned individual with strong financial acumen and a passion for nonprofit financial management. You will play a key role in supporting the organization’s long-term sustainability while ensuring compliance, transparency, and accountability to internal and external stakeholders, including the Board of Directors, donors, and regulatory agencies.

Key Responsibilities

Financial Leadership & Strategy

• Contribute to the organization’s financial strategy in alignment with mission and goals
• Provide financial insights and analysis to support decision-making by the Executive Director and Board of Directors
• Lead financial planning activities including annual budgeting, forecasting, and long-term financial modeling
• Oversee preparation for the annual independent audit and timely filing of IRS Form 990

Financial Management

• Manage day-to-day financial operations, including banking, credit cards, accounts payable/receivable, and reconciliations
• Prepare monthly management accounts, cash flow reports, and grant tracking updates
• Oversee U.S. nonprofit regulatory filings, including IRS reporting, state charitable registrations, and donor acknowledgments
• Maintain strong internal financial controls and compliance
• Liaise with Kids Operating Room UK finance team on cross-border grants, shared budgets, and project-level reporting

Payroll and HR Administration

• We use a hybrid payroll model: in-house administration with outsourced payroll processing
• Administer onboarding, employment contracts, and monthly payroll data
• Coordinate monthly payroll compilation and changes for external processing
• Manage employee benefits including healthcare and retirement plans
• Ensure payroll compliance with IRS and state tax authorities
• Support financial aspects of onboarding/offboarding, and performance and compensation processes
• Maintain employee records and assist with HR policy updates and compliance

Risk Management & Governance

• Identify and manage financial and operational risks, implementing mitigation strategies as needed
• Maintain strong governance practices in collaboration with auditors and the Board
• Support development and implementation of policies for ethical financial stewardship, reserves, investments, and sustainability
• Ensure proper record-keeping and compliance with nonprofit governance standards

Business Services

• Manage vendor contracts, procurement, and administrative systems
• Support staff with scheduling, donor CRM management, and internal systems
• Partner with global colleagues to streamline processes and align business services with organizational strategy

Qualifications

• Bachelor’s degree in finance, accounting, nonprofit management, HR, or related field (CPA certification a plus)
• Minimum of 5 years of experience in nonprofit financial and operational management, ideally in healthcare or international development
• In-depth knowledge of U.S. nonprofit regulations, financial reporting (IRS Form 990), and internal controls
• Hands-on experience with payroll administration and benefits management using a hybrid payroll model
• Proficiency with QuickBooks, payroll platforms, and donor CRM systems
• Highly organized and detail-oriented; able to work independently and collaboratively in a remote environment
• Strong alignment with the mission and values of Kids Operating Room and a commitment to global health equity