Head of Accounting
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Job Description
Head of Accounting for healthcare advocacy startup building the accounting function and leading audit readiness. Responsible for financial reporting and implementing best practices.
Responsibilities:
- Design and run the monthly close (calendar, checklist, cutoffs, review standards, reconciliations, variance analysis).
- Ensure the GL is accurate and the balance sheet is clean, supported, and reconcilable at all times.
- Establish accounting policies and judgment frameworks appropriate for our business and stage.
- Define the chart of accounts and reporting structure to support operational reporting and future scalability.
- Implement best-practice processes for account reconciliations, journal entry controls, and documentation standards.
- Create lightweight, high-signal internal controls (approvals, access, segregation where possible, evidence standards).
- Own the audit readiness roadmap (even if we’re not audited today): close discipline, documentation, tie-outs, and issue tracking.
- Manage external partners as needed (audit firm, tax preparers, bookkeeping support if any).
- Drive PBC requests and ensure support is consistent, complete, and reviewable.
- Evaluate and recommend tooling (ERP readiness, expense/AP tools, close management) and lead implementation when needed.
- Partner with FP&A, Ops, Sales, and People to improve upstream data quality and establish reliable accounting inputs.
- Build scalable processes for spend management, vendor/customer workflows, and accounting ops.
- Hire and develop the first accounting team over time (Staff/Senior/Manager), and create clear standards for quality and pace.
- Coach through review, clear expectations, and process design—not just “do the work faster.”
Requirements:
- 6+ years of progressive accounting experience; Big 4 background strongly preferred.
- Proven track record owning a close process end-to-end and improving it over time.
- Hands-on operator mentality: you can design processes and also execute journal entries/reconciliations when needed.
- Strong accounting judgment and ability to translate ambiguity into decisions, documentation, and repeatable processes.
- Experience partnering cross-functionally and driving accountability without creating chaos.
- Comfort operating in a “blank page” environment with evolving systems and priorities.
- CPA.
- Experience in a high-growth startup or scaling environment (first accounting hires, messy inputs, evolving systems).
- ERP implementation or migration experience (NetSuite preferred).
- Experience with revenue recognition (ASC 606) and multi-entity structures
- Exposure to SOC readiness / controls design
Benefits:
- Health insurance
- Flexible working hours
- Professional development opportunities
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