Senior Manager, Revenue Accounting

About NexHealth
Our healthcare system remains frustratingly analog. When you live in a world of one-tap car rides, instant meal delivery, and unlimited streaming, why do you still have to call to schedule a doctor’s appointment and fill out a clipboard in the waiting room?
NexHealth’s mission is to accelerate innovation in healthcare by connecting patients, providers, and developers. We’re building the infrastructure layer for modern healthcare , connecting thousands of fragmented, on-premise, and closed EHR systems into a single, modern platform that powers software, APIs, payments, and patient experiences across the ecosystem.
- Founded: 2017
- Headquarters: San Francisco, CA
- Funding: $177M Series C
- Employees: 200+
- Trusted by tens of thousands of providers and hundreds of health-tech developers — forging the infrastructure layer that modern healthcare needs

About the Role
NexHealth is in a high-growth stage, with a revenue mix diversifying into payments, API/usage-based, and marketplace models on top of our core SaaS subscription business. We're transitioning SaaS pricing from fixed-fee toward consumption-based models, pushing more customers toward longer-term and multi-year agreements, and migrating our billing infrastructure from Chargebee to Stripe following the recent launch of our new CPQ-to-Stripe quote flow.
This role is the senior technical authority on revenue accounting at NexHealth: owning ASC 606 policy and judgment calls independently, assessing and advising on our evolving pricing structure to help the company grow while ensuring our reporting reflects it accurately, and serving as the primary point of contact for auditors on all revenue matters — all while building the Order-to-Cash function to support our next stage of growth.
What You'll Do
- Own the Order-to-Cash function end to end (billing, collections, sales tax, MRR/ARR reporting and accounting, etc.) and co-lead the design and build-out of our go-forward billing engine on Stripe, from architecture through the Chargebee migration.
- Own ASC 606 revenue recognition policy end to end as we shift toward consumption-based pricing and multi-year agreements.
- Partner with RevOps, Engineering, and Product to ensure the CPQ-to-billing pipeline holds up as transaction volume and deal complexity grow, and that underlying data flowing from Salesforce to Stripe and Snowflakes supports all critical downstream reporting (ie. MRR/ARR/CARR reporting).
- Co-own our ARR/Bookings/MRR Definitions Memo, Revenue Recognition Matrix (mapping common contract terms to their revenue treatment for Sales/RevOps self-service), Discount Authority Matrix, and related pricing governance documents with RevOps and Sales leadership.
- Reviewing contracts with Sales/RevOps for rev rec impact before signature, and briefing the Controller and CFO on key judgment calls. Co-lead our CPQ flow with the deal desk function as we build it out, serving as the revenue accounting voice on non-standard terms and deal structuring.
- Lead the Order-to-Cash team — coaching our billing/collections and reporting staff through new pricing and process rollouts, revenue reportings, owning the accuracy of revenue journal entries each close.
- Serve as NexHealth's primary point of contact with auditors on all revenue matters.

What Success Looks Like
- All of our revenue streams have documented SOP, defensible ASC 606 treatment, and MRR/ARR/CAR reporting accurately reflects them — trusted by the whole company and our investors.
- The Chargebee-to-Stripe billing migration has a clear design, solution, and project plan in place — built for automation and scalability to support our growth — ready for execution with a clean audit trail and no gaps in revenue data through cutover.
- The billing operations team is confidently running day-to-day billing, collections, and reporting under the processes and policies you've built, with clear ownership of revenue journal entries.
- You're the trusted owner