Who we are:
Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.
What you’ll do:
We are seeking a motivated and detail-oriented Practice Accounting Manager to join our Accounting team. This role will report to the Practice & ASC Controller and will be responsible for owning the monthly accounting close, trial balance review, and P&L analysis for Spire’s Practice center service line, currently consisting of twelve Practices.
This role will be a key Accounting partner to FP&A and Operations, helping explain monthly results, account fluctuations, journal entries, and service-line trends. The ideal candidate will have strong month-end close experience, a solid understanding of US GAAP, strong judgment around journal entry review and support documentation, and an interest in partnering with the business beyond simply closing the books.
Responsibilities/Duties:
- Own the monthly close process for the Practice service line, including review of full trial balances and P&Ls for assigned Practice entities.
- Prepare, review, and approve journal entries in accordance with US GAAP and company policies.
- Review monthly account reconciliations and ensure balances are properly supported, documented, and cleared timely.
- Analyze monthly P&L and balance sheet activity, including explaining significant account fluctuations, unusual trends, and key drivers of results.
- Serve as a primary Accounting contact and lead conversations for Practice-related questions from FP&A, Operations, and management.
- Partner with FP&A on monthly operating reviews, 3-statement model support, actuals explanations, and close-to-forecast tie-outs.
- Coordinate with Operations to better understand Practice trends, activity drivers, and business changes that may impact monthly accounting results.
- Provide oversight and coaching to Practice accounting staff/senior accountant resources.
- Support review of Practice-related areas such as accruals, AP activity, cash activity, fixed assets, inventory, leases, payroll-related entries, revenue entries, and other close activities.
- Proactively identify process gaps, documentation needs, and opportunities to improve close efficiency and financial reporting quality.
- Maintain strong support documentation for journal entries, reconciliations, variance explanations, and audit requests.
- Assist with internal and external audit requests, including preparation of schedules and support.
- Collaborate with cross-functional teams, including Accounting, FP&A, Operations, Revenue Cycle, Treasury, AP, Payroll, and external auditors.
- Support continued development of accounting processes, controls, and reporting cadence as Spire continues to grow.
Who you are:
Qualifications:
- Bachelor’s degree in Accounting, Finance, or a related field required.
- 2–5 years of accounting or month-end close experience preferred.
- CPA designation or progress toward certification is a plus, but not required.
- Strong understanding of general ledger accounting, journal entries, account reconciliations, and the relationship between the P&L and balance sheet.
- Working knowledge of US GAAP appropriate for level of experience.
- Ability to analyze account activity and explain monthly balance sheet and P&L movement.
- Strong documentation skills and attention to detail.
- Strong communication skills and willingness to work with Accounting, FP&A, Operations, AP, Payroll, Treasury, Revenue Cycle, and external auditors.
- Experience with BlackLine or other account reconciliation tools is a plus.
- Experience with Sage Intacct or similar accounting systems is a plus.
- Intermediate to advanced Excel skills preferred.
- Healthcare, physician practice, multi-site, or private equity-backed company experience is a plus, but not required.
What we offer:
- Excellent growth and advancement opportunities
- Dynamic environment
- Access to a diverse network of practitioners
- Broad infrastructure of tools and programs to enhance the employee experience
- Competitive Compensation
- Generous PTO
- Benefits package: health, dental, vision, 401(k), etc.
We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).
The final pay offered to a successful candidate will be dependent on several factors that may include but are not limited to the type and years of experience within the job, the type of years and experience within the industry, education, etc.
Skills Required
- Bachelor's degree in Accounting, Finance, or related field
- 2-5 years of accounting or month-end close experience
- CPA designation or progress toward certification
- Strong understanding of general ledger accounting, journal entries, and account reconciliations
- Working knowledge of US GAAP
- Ability to analyze account activity and explain monthly balance sheet and P&L movement
- Strong documentation skills and attention to detail
- Strong communication skills and ability to collaborate with Accounting, FP&A, Operations, AP, Payroll, Treasury, Revenue Cycle, and auditors
- Experience with BlackLine or other account reconciliation tools
- Experience with Sage Intacct or similar accounting systems
- Intermediate to advanced Excel skills
- Healthcare, physician practice, multi-site, or private equity-backed company experience
- Experience preparing, reviewing, and approving journal entries and account reconciliations as part of month-end close
What We Do
Spire Orthopedic Partners is a management services organization (MSO) that partners with leading orthopedic and spine practices. It provides the necessary infrastructure, capital, and administrative support—including finance, operations, and marketing—to enable physicians to focus on patient care. The company operates across the Northeast, supporting elite practices to help them grow, specialize, and thrive in a competitive healthcare landscape while maintaining clinical autonomy.


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