Own US GAAP-compliant accounting, revenue recognition (ASC 606), and multi-entity consolidation. Manage month-end close, GL integrity, intercompany transactions, and financial reporting accuracy. Maintain internal controls and policies for public-company readiness. Prepare and lead annual external audits and manage auditor relationships. Ensure compliance with health-care related financial regulations (SOC2, HIPAA-related processes). Prepare global financial statements and management reporting. Present reporting and control environment updates to the Audit Committee. Support technical accounting research and implementation of new standards. Track performance and margins across multiple revenue streams. Partner with Commercial and Revenue Operations to strengthen data integrity. Manage US and international tax compliance (VAT, sales tax, income tax). Oversee R&D tax credit processes. Drive automation and efficiency in tax data collection and filing. Design and improve scalable accounting workflows (AP, AR, payroll, spend approval). Deploy and optimize financial systems (ERP, spend management, travel). Lead automation to reduce manual work and shorten time-to-close. Lead and coach a geographically distributed Accounting team (US + Europe). Build capabilities and uplift developing talent; recruit where needed. Ensure accurate accounting for equity transactions, debt financing, and fundraising events. Support corporate structuring and M&A integration activities.