Manager/Sr. Manager, Revenue Accounting

AcuityMD is a software and data platform that accelerates access to medical technologies. We help MedTech companies understand how their products are used, why customers vary, and identify opportunities for physicians to better serve their patients. Each year, the FDA approves ~6,000 new medical devices. Our solution helps MedTech companies get these products to physicians more effectively so they can improve patient care with the latest technology. We're backed by Benchmark, Redpoint, ICONIQ Growth, and Ajax Health. We’re a high-growth SaaS company scaling rapidly.

In this role, you will build and scale a best-in-class revenue accounting function during a period of rapid growth. You will ensure accurate, timely, and compliant revenue recognition while partnering cross-functionally to bring clarity to complex commercial arrangements. Your work will directly enable the company to scale efficiently, make informed decisions, and invest confidently in accelerating patient access to cutting-edge medical technology.

Business Operations & Finance exists to resolve ambiguity at AcuityMD. We’re a team of business generalists unifying AcuityMD’s business strategy with available resources. We aim to improve collaboration in evolving business processes during rapid growth. We push progress on central planning initiatives, including measuring and improving business performance, driving clarity on company goals, and aligning the leadership team on critical business initiatives. Over time, we build the organizational capacity for teams to operate without us.

ASC 606 Technical Leadership & Policy

Own Revenue Recognition:

• The ASC 606 authority for all contract types — subscription, usage-based, professional services, and enterprise — ensuring accuracy and audit-readiness at all times.

NPI, SSP & Position Papers:

• Define performance obligations at product launch, maintain SSP analyses as the portfolio evolves, and keep a library of audit-ready position papers across all material judgments.

Deferred Commissions (ASC 340-40):

• Own capitalized contract cost accounting end-to-end — policy, amortization, impairment, and period-end close.

Scalable Process Design & Public Company Readiness

• Build for Scale:
  • Design controls, workflows, and a tiered contract review framework — materiality thresholds, intake SLAs, and close processes — built to public company standards well ahead of when they're required.
• Contract Review Framework:
  • Establish tiered intake, materiality thresholds, and SLAs that ensure all new and amended contracts receive timely assessment aligned to deal desk timelines.
• Month-End & Quarter-End Close:
  • Own revenue close — deferred revenue, commission assets, contract reconciliations — and the sub-ledger integration between HubSpot and Rillet, with clear controls from booking to recognition.

Cross-Functional Partnership & Revenue Guidance

• Deal Desk Partner:
  • Fast, clear guidance on non-standard terms — modifications, variable fees, side letters — without slowing deals.
• Cross-Functional Influence & Education:
  • ****Partner with Sales, RevOps, Legal, and Finance to catch revenue implications early, shape deal structures, and run periodic training that reduces accounting fire drills before they start.

• Bachelor's in Accounting or Finance; CPA strongly preferred. Big 4 or national firm background a plus.
• 8+ years in public accounting and/or high-growth SaaS, with deep ASC 606 expertise — position papers, SSP analyses, and auditor defense included.
• Experience owning ASC 340-40 deferred commission accounting from policy through close.
• Track record interpreting complex multi-element contracts across subscription, usage-based, and enterprise structures.
• Proven ability to build scalable accounting infrastructure in fast-paced, high-growth environments with an eye toward public company standards.
• Communicates complex GAAP clearly to Sales, Legal, and executive stakeholders.
• Ready to hire and develop a 2-3 person team within 12-18 months.
• Experience with modern cloud ERP systems (Rillet experience a plus); familiarity with revenue automation tools and disclosure requirements.

• B2B SaaS experience, ideally MedTech or a regulated vertical.
• Usage-based or hybrid pricing model experience and related ASC 606 implications.
• Experience implementing a rev rec system (Maxio, Zuora Revenue, RevPro, or similar).
• Exposure to SOX scoping, ICFR design, or Big 4 public company readiness work.
• Familiarity with HubSpot CRM and its integration to the revenue sub-ledger.

AcuityMD is committed to providing highly competitive cash compensation, equity, and benefits. The compensation offered for this role will be based on multiple factors such as location, the role’s scope and complexity, and the candidate’s experience and expertise, market data and may vary from the range provided. Base salary range: $170,000-$210,000

You must have an eligible work permit in the USA to be considered for this position

• Ground floor opportunity: Join a high-growth startup, backed by world-class investors across Enterprise SaaS and Medical Devices (Benchmark, Redpoint Ventures, and Ajax Health).
• Learning Budget: Reimbursements for relevant learning and up-skilling opportunities.
• Remote work: AcuityMD is committed to supporting full-remote flexibility for employees in the US. We provide a work-from-home stipend for all employees.
• Flexible PTO: Generous time off and flexible hours give you the freedom to do your best work.
• Paid Health, Dental, and Vision Plans: We offer 100% paid health, dental, and vision plans for all employees and 75% paid for our employees' dependents.
• Home Office Stipend: $1,000 to invest in remote office equipment and WiFi reimbursement.
• Optional Team Retreats: We meet in-person multiple times per year for co-working and social gatherings.
• Parental Leave: 8-16 weeks of fully-paid, flexible parental leave.

The Company: We are builders, who are inspired by our mission to expand patient access to cutting-edge medical technologies. We value working collaboratively to solve hard problems for our customers with simple, innovative solutions. We push ourselves to learn with empathy. We foster an active culture of mentorship and inclusion, and we welcome new team members that share our values.

We're backed by Benchmark, Redpoint Ventures, Ajax Health, and several other leading software and medical device investors. Since Acuity launched in 2020, we've brought on customers ranging from publicly traded Fortune 500 companies to innovative growth-stage companies and regional medical device distributors.

The Product: AcuityMD uses data and software to help teams collaborate around the complex relationships they have with the users of medical technologies: doctors. Our platform empowers medical technology companies to see how their products are used, understand why outcomes vary, and identify opportunities where physicians or sites of care can better serve their patients.

AcuityMD is an Equal Opportunity Employer

AcuityMD is seeking to create a diverse work environment because all teams are stronger with different perspectives and life experiences. We strongly encourage people of all backgrounds to apply. We do not discriminate on the basis of race, gender, religion, color, national origin, sexual orientation, age, marital status, veteran status, or disability status. All employees and contractors of AcuityMD are responsible for maintaining a work culture free from discrimination and harassment by treating others with kindness and respect.