Reports to: Controller
About this Role
Midi Health is seeking a hands-on Senior Accountant with strong inventory and cost accounting experience to support core accounting operations in a fast-growing, venture-backed healthcare and technology environment. This role is critical to maintaining accurate financials, strengthening close processes, and supporting compliance across revenue, payroll, and sales tax as the company scales.
This is a high-impact, hands-on role requiring a proactive approach. The Senior Accountant must be able to own areas end-to-end, identify issues before they become problems, and operate effectively in a dynamic, evolving environment..
Key ResponsibilitiesInventory & COGS OwnershipThis role will own and manage inventory-related accounting, including:
- Maintain accurate inventory records across raw materials, WIP (if applicable), and finished goods.
- Ensure proper inventory valuation in accordance with GAAP.
- Record and reconcile inventory purchases, usage, write-offs, obsolescence, and adjustments.
- Calculate and reconcile COGS, including pharmacy and supplement-related product costs, freight, and other landed costs.
- Perform monthly inventory roll-forwards and tie-outs to the general ledger.
- Partner closely with Operations and Supply Chain to investigate and resolve complex inventory variances.
- Own key areas of the monthly close process, including journal entries, reconciliations, and variance analysis.
- Prepare and review balance sheet reconciliations (cash, AR, AP, accrued expenses, payroll, equity).
- Ensure timely, accurate financial reporting in accordance with GAAP.
- Support revenue recognition under ASC 606, including analysis of contracts, reimbursements, and pharmacy-related transactions.
- Lead reconciliation of medical vs. product revenue streams.
- Partner with FP&A and Finance leadership on revenue reporting accuracy.
- Reconcile payroll, benefits, and related accruals across multi-state operations.
- Support stock-based compensation accounting under ASC 718, including monthly expense entries and reconciliations.
- Ensure compliance with state and local sales tax filings and reconciliations (product and healthcare-related taxes).
- Support audits (financial, sales tax, and other compliance reviews).
- Maintain accurate accounting records within the ERP, and leverage system capabilities to identify and resolve process inefficiencies.
- Support implementation of new tools, policies, or accounting standards as needed.
- Support external auditors and consultants.
- Prepare schedules and analyses for leadership, fundraising, and board reporting.
- Collaborate closely with Finance, Operations, Payroll, and Revenue teams.
Required
- Bachelor’s degree in Accounting or Finance, or equivalent.
- 4–7+ years of progressive accounting experience
- Strong knowledge of GAAP; experience with ASC 606 required
- Experience in healthcare, technology, or high-growth environments
- Advanced proficiency in Excel (e.g., pivot tables, VLOOKUP, complex formulas) and experience working with large datasets.
- Experience with NetSuite, Sage Intacct, or similar ERP systems
Preferred
- CPA or CPA-track
- Experience with multi-entity or multi-state operations
- Prior experience with accounting or tax system implementation or significant migration projects.
- Familiarity with sales tax automation tools (Avalara, Sphere, Anrok, etc.)
- Prior experience in a startup or PE/VC-backed company
- Month-end close runs smoother and faster
- Reconciliations are clean, documented, and review-ready
- Revenue and payroll reporting issues are identified early—not during audits
- Finance leadership trusts your numbers without re-checking them
- Mission-driven healthcare company improving access to women’s healthcare
- Remote-first, flexible work environment
- High-Growth Opportunity: Play a pivotal role in scaling the finance function and take on increasing ownership as the company expands.
- Strategic Impact: Gain direct exposure to senior finance leadership, contributing to strategic initiatives and board-level reporting.
The base salary range is $130-140K, dependent on experience. Midi provides a competitive base salary, plus equity and benefits.
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At this time, Midi is unable to provide visa sponsorship. All Candidates must be authorized to work in the United States without current or future sponsorship needs.
Please note that all official communication from Midi Health will come from an @joinmidi.com email address. We will never ask for payment of any kind during the application or hiring process. If you receive any suspicious communication claiming to be from Midi Health, please report it immediately by emailing us at [email protected].
Midi Health is an Equal Opportunity Employer. We are committed to pay equity and ensure that all qualified applicants receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Our compensation philosophy is based on fair, objective criteria and the impact of the role, regardless of an applicant’s salary history.
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Midi Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Midi Health and has not been reviewed or approved by Midi Health.
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Equity Value & Accessibility — Equity is positioned as a meaningful part of the package, with multiple passages describing “strong equity grants” and equity-heavy total compensation in some roles. Equity upside is framed as a key offset when cash compensation is viewed as less competitive.
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Healthcare Strength — Medical, dental, and vision coverage is repeatedly described as comprehensive, including employer-covered premiums in some descriptions and women’s health-aligned services. Mental health support and menopause-specific care are also presented as part of the health offering.
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Leave & Time Off Breadth — Time-off benefits are described as flexible, including unlimited PTO and remote-first support such as equipment or home-office stipends. These elements are portrayed as improving overall rewards even when base pay is debated.
Midi Health Insights
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What We Do
Meet Midi: The only virtual care platform focused on female midlife health. Our care is designed by world class experts in perimenopause, menopause, and more. Everything we do serves our mission—to help women feel strong and healthy through a critical chapter of their lives and careers. We take a holistic approach to improve the symptoms of midlife hormone change, based on every woman’s health history, lifestyle, and genetics. Our customized Care Plans include: - Prescription hormonal and non-hormonal medications (including HRT) - Lifestyle coaching and wellness therapies - Supplements and botanicals - Specialized care paths for cancer survivors and those at risk Midi visits and prescriptions are covered by most PPO insurance plans. We also integrate with employers and the entire benefits ecosystem to offer a fully-reimbursed medical program, because we believe great care should be accessible AND affordable.
