Head of Accounting

Adaptive Innovations • New York, NY

6d • Hybrid

About The Position

The Head of Accounting reports to the Head of Finance and owns the accuracy and integrity of the company’s financial reporting. This role leads the accounting function, including the Controller, Senior Accountant, Payroll Manager, and AP Specialist, and builds the controls and systems needed to support company growth.

The role oversees the general ledger, monthly, quarterly, and annual close, and consolidated US GAAP financial statements, including multi-entity consolidation and intercompany accounting. It leads 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. The Head of Accounting also leads audits and lender, investor, and regulatory reviews; operates internal controls; oversees core accounting operations, tax compliance, and the accounting technology stack; supports M&A; and hires and develops the accounting team.

Success in the role means producing accurate and timely financial statements, reliable healthcare revenue estimates, an efficient close, and an accounting function that is consistently audit-ready. The role is hybrid, with 3–4 days per week in the New York City office.

Requirements

• 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.

Nice To Haves

• 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.

Responsibilities

• 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.

Benefits

• Competitive salary and equity compensation
• Comprehensive health insurance, dental, and commuter benefits
• 401(k) retirement plan with employer contribution
• Flexible time off policy — the company expects most employees to take at least 3 weeks of vacation per year
• In-office lunches, dinners, and snacks
• Opportunity for growth in a fast-growing company
• Collaborative team valuing innovation and problem-solving

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed