Head of Accounting

New York, New York · Remotefull time

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Remote

senior

H1B: no

Adaptive Innovations Head of Accounting responsible for leading the accounting function and ensuring accuracy and integrity of financial reporting under US GAAP. Manages general ledger, revenue accounting, audits, internal controls, and accounting systems.

Responsibilities

As Head of Accounting, reporting to the Head of Finance, you will own the accuracy and integrity of our financial reporting. You will lead the accounting function, including the Controller, Senior Accountant, Payroll Manager, and AP Specialist, and build the controls and systems that support our growth.
Own the general ledger, monthly, quarterly, and annual close, and consolidated financial statements under US GAAP, including multi-entity consolidation and intercompany accounting.
Lead healthcare revenue accounting under ASC 606 across fee-for-service, payer contracts, patient responsibility, government programs, and value-based care arrangements, including gross-to-net estimates, contractual allowances, and price concessions.
Lead the annual financial statement audit and lender, investor, and regulatory reviews, delivering clean, timely financial reporting.
Design, document, and operate internal controls, preparing for SOX-level requirements if and when needed.
Oversee accounts payable, accounts receivable and cash application, payroll accounting and compensation administration, fixed assets, prepaids, accruals, and treasury operations.
Manage tax compliance and external advisors.
Own the accounting stack, including Campfire, Ramp, HCHB, and internal tools; use AI and automation to reduce manual work while maintaining accuracy and controls.
Support M&A through accounting diligence, purchase accounting, and post-close integration.
Hire, develop, and lead the accounting team.
Success means accurate, timely financial statements, reliable healthcare revenue estimates, an efficient close, and an accounting function that is consistently audit-ready.

Qualification

DeepExceptional attention to detailMulti-entityPractical experience using data

Required

Active CPA with a foundation in Big Four or national public accounting.
10+ years of progressive accounting experience, including 5+ years leading an accounting function inside a healthcare company as a Controller, VP Controller, or Head of Accounting.
Deep, current expertise in ASC 606 for healthcare revenue, including payer contracting, reimbursement, contractual allowances, price concessions, and net revenue estimation.
A track record of closing the books accurately within 10 business days or fewer and delivering clean, on-time audits.
Experience designing and operating internal controls and building the control environment of a growing company.
Exceptional attention to detail, clear written communication, and sound judgment about when to escalate issues to leadership.

Preferred

Public accounting experience auditing healthcare clients.
Experience at a PE-backed or venture-backed healthcare company through a financing, acquisition, or sale, including quality-of-earnings and diligence work.
Multi-entity, multi-state healthcare experience, including roll-up or de novo structures and MSO arrangements.
Experience building an accounting function from an early-stage close process to institutional-grade reporting and controls.
Practical experience using data, AI, and automation to eliminate manual accounting work.