Head of Accounting

Adaptive Innovations; New York (NY); Hybrid; USD 190,000 - 230,000; Full time

Benefits offered by this job

Competitive salary

Equity compensation

Health insurance

Job summary

Adaptive Innovations Inc. in New York City seeks a Head of Accounting to lead the finance function, reporting to the Head of Finance. You will manage the controller, payroll, AP/AR, and treasury, driving accurate, audit-ready financials and scalable controls for a fast-growing AI healthcare company.

The role requires a CPA, 10+ years of accounting, and deep ASC 606 healthcare revenue expertise. It offers a hybrid NYC work arrangement and opportunities to shape finance operations as the company

Qualifications

• Active CPA with healthcare accounting experience is required.
• Over 10 years of progressive accounting experience, 5+ in leadership.
• Deep ASC 606 expertise for revenue in healthcare.
• Strong ability to close books quickly with audits.
• Experience building internal controls in growing companies.

Responsibilities

• Own GL, monthly/quarterly/annual close and consolidation under US GAAP.
• Lead healthcare revenue accounting including ASC 606 processes.
• Guide annual audits and external reviews with lenders/investors.
• Design internal controls and SOX readiness when needed.
• Oversee payables, receivables, payroll, assets, and treasury.
• Support M&A diligence and post-close integration.
• Build and lead a growing accounting team.

Skills

CPA

ASC 606 expertise

GAAP accounting

leadership

healthcare accounting

Tools

Campfire

Ramp

HCHB

Job description

About Us

We are fixing US healthcare by building an AI-native physical care platform, starting with home health.

Home health is a $140B industry with less than $10B in EBITDA — 40% of revenue is spent on pure administrative waste. We automate this work with AI, creating a fundamentally different cost structure compared to incumbents. This lets us rapidly take market share by serving the 30% of patients who go untreated today.

By reshaping the cost structure of this industry, we unlock its growth.

We've built one of the best AI teams in the world (from Character AI, Scale, Palantir, Citadel, Jane Street) and paired them with a team of healthcare veterans to build a new type of healthcare company: one that delivers care at the speed of an AI company.

Our physical care platform already operates with 30pp higher gross margins than traditional home health providers. With our AI advantage, we pay nurses more, remove their admin burden, and unlock the scale economics that have been missing from this fragmented industry. If we served this entire $140B market, instead of $10B in EBITDA, we'd drive $60B.

We're starting with home health, then expanding to all delivered care. Our mission is "any care, any where".

Fundamentally, our incentives are aligned with America. Every dollar in revenue we make is two dollars taken out of the healthcare system. If we succeed, so does US healthcare.

What You’ll Do

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.

Basic Qualifications

• 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 escape issues to leadership.

Preferred Qualifications

• 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.

What We Offer

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

Location

This role is hybrid, with 3–4 days per week in our New York City office.