Accounting Manager

About Eko Health Eko builds AI and digital tools to enable every healthcare provider to more accurately detect heart and lung disease – the leading causes of death globally. Our FDA cleared, industry leading products are used by hundreds of thousands of clinicians on millions of patients around the world. With Eko, clinicians can detect cardiac and pulmonary disease with higher accuracy, diagnose with more confidence, manage treatment effectively, and ultimately give their patients the best care possible. We have strong venture capital backing from investors like Artis Ventures, Questa Capital, Highland Capital, and Mayo Clinic Ventures. Recognized by TIME magazine in 2025 as one of the world’s top healthcare technology companies, Eko is one of the fastest growing digital health companies with products used around the world at some of the most prestigious health systems. We have more than 8 FDA clearances including novel AI algorithms, and we invest heavily in quality clinical research and R&D to build and validate exceptional products for patients we care deeply about. We’ve built a mission driven, high performing, talented, and diverse team of engineers, physicians, PhD’s, creatives, and technologists. We are committed to investing in each other and our mission to ensure all patients have access to high quality care. We are headquartered in Emeryville, California and privately-held with world class investors and partners. Role Summary Eko Health builds devices and software that help clinicians detect heart and lung disease earlier. We’re looking for a Manager, Cost Accounting & Procure-to-Pay, remote in the US on Pacific hours, to own two things at the center of our business: what it costs us to put a device in a clinician’s hands, and how we pay for everything that gets it there. This is a build role. Reporting to the Corporate Controller, you will set Eko’s costing methodology and defend it to our auditors, own inventory valuation and reserves, run landed cost end to end, close COGS each month, and run procure-to-pay from purchase order to payment. You will partner with Supply Chain, Sales Operations, and FP&A, and your margin analysis will reach the executive team. You inherit a working foundation and a lot of room to make it better. A few things make this role unique. Eko does not run a factory: devices are built by contract manufacturers and bought as finished goods, so cost is purchase price plus landed cost, and inventory sits with partners we cannot walk into. Hardware is sold alongside subscription software, so the margin story is blended. And this is a hands-on manager role with no direct reports to start: you provide review oversight to our offshore transactional team while personally owning the higher-judgment accounting, reconciliations, close, and conclusions. If you like building both the methodology and the reconciliation behind it, you will thrive here. Essential Functions Costing methodology: standard cost setting, cost rolls, purchase price and landed cost variance, and the policy behind them. Landed cost end to end: accruing duty, tariffs, freight, and brokerage at receipt, truing up on the broker invoice, and allocating correctly between inventory and cost of sales, in partnership with Supply Chain and our customs brokers. Inventory valuation under US GAAP (ASC 330, lower of cost or net realizable value) and the excess and obsolete reserve, with methodology you can defend to an external auditor. Inventory integrity across our contract manufacturer, 3PL, and marketplace locations: reconciliation cadence, cycle count protocols, cutoff, and audit confirmation or observation. Procure-to-pay: PO policy, vendor master governance, three-way match, received-not-invoiced, payment runs and disbursement controls, and the AP close. The COGS close and gross margin analytics across hardware and subscription revenue, in partnership with FP&A. Audit and control design for the inventory, cost, and P2P cycles, built to withstand SOX and external audit scrutiny. Required Qualifications 7+ years in cost, inventory, or manufacturing accounting, including hardware, medical device, electronics, or another inventory-intensive product environment. Hands-on ownership of landed cost, inventory valuation, and the inventory close, ideally where manufacturing was outsourced and stock was held by third parties. Hands-on ownership of accounts payable operations, including vendor master controls, three-way match, payment runs, and the AP close. Experience supporting external audit testing of inventory valuation and reserves under US GAAP, and the ability to explain how you defended a position. Comfort owning ambiguous, cross-system reconciliations, advanced Excel, and the ability to present a conclusion to Finance leadership and hold it under questioning. Bachelor’s degree in Accounting or Finance. CPA, CMA, or equivalent preferred. Nice to have: NetSuite, customs and import exposure, 3PL or e-commerce operations, AP automation platforms, SOX, and experience building processes from a low baseline in a high-growth or pre-IPO company