Senior Accountant

Overview

A healthcare organization focused on transforming cardiovascular care in the United States is seeking a Senior Accountant to establish and lead its accounting function. This role involves building financial systems and processes from the ground up, managing the financial close, and leading the company through its first external audit.

Responsibilities

• Lead month-end close process ensuring it is clean, timely, and well-documented.
• Produce monthly internal financial statements and analytics for board reporting.
• Prepare for and serve as the primary contact for external auditors during the first full audit.
• Design, document, and operate the end-to-end accounts payable process including vendor onboarding, bill review, payments, and expense management.
• Manage recurring balance sheet reconciliations across cash, prepaids, fixed assets, accruals, and intercompany accounts.
• Develop and maintain accounting policies and internal controls, including revenue recognition, capitalization, and lease policies.
• Collaborate cross-functionally with Operations, People, and Clinical leadership on accounting implications of contracts, programs, and hires.

Success Milestones

At 90 Days:

• Fully own the close process with replicable reporting and infrastructure.
• Accounts payable process documented and operational.
• Complete a current-state diagnostic with a prioritized roadmap.

At 6 Months:

• Consistently complete close on target date.
• Deliver reliable and largely automated monthly board reporting.
• Make significant progress on audit readiness.

At 12 Months:

• Complete first full external audit with a clean opinion.
• Achieve a close cycle of 5 business days with all reconciliations current.
• Fully automate accounts payable; prepare accounting infrastructure to support doubling company scale.

Requirements

• 5–8+ years of progressive accounting experience, ideally starting in public accounting and followed by industry experience at a venture-backed or scaling company.
• Active CPA license or CPA-eligible with imminent licensure.
• Proven end-to-end ownership of month-end close in a high-growth environment.
• Strong technical accounting knowledge under US GAAP.
• Experience leading or supporting early-stage external audits.
• Demonstrated ability to design and document accounting processes from scratch.
• High attention to detail, resourcefulness, and comfort with ambiguity.

Preferred Qualifications

• Experience in healthcare, particularly value-based care, MSO/management services, or provider services.
• Proficiency with QuickBooks.
• Experience implementing accounts payable automation and expense management tools such as Ramp or Brex.
• Familiarity with revenue recognition for service contracts or risk-based arrangements.
• Knowledge of payor data, capitation, or shared-savings accounting.

Location

The role prefers candidates based in Nashville but is open to applicants located in Washington DC, Boston, New York City, or those working remotely within the Eastern Time Zone.