Bookkeeping & Payroll Manager

Compensation:
Competitive; commensurate with experience and scope

Shield Health is a fast-growing healthcare startup reimagining chronic care management for patients nationwide. By partnering with physicians, we deliver high-touch, personalized care that improves outcomes and reduces costs.

As we scale, we’re looking to bring greater ownership and structure to our financial operations.

As Bookkeeping & Payroll Manager, you’ll own Shield Health’s day-to-day bookkeeping and payroll operations—ensuring clean books, accurate payroll, and minimal leadership involvement. This role is ideal for someone who enjoys bringing order to financial systems, operating independently, and playing a meaningful role in scaling a fast-growing healthcare company. You’ll work closely with company leadership, have real ownership over core financial operations, and gain opportunities to expand scope and influence as the business grows.

This role is expected to start part-time, with flexibility to expand based on business needs and fit.

• Maintain clean, accurate financial records in Quick Books
• Own day-to-day bookkeeping and general ledger maintenance
• Perform reconciliations and ensure books are consistently up to date
• Partner with external accountants as needed
• Bring consistency and structure to bookkeeping workflows
• Own end-to-end payroll execution using Gusto
• Manage multi-state payroll accurately and on time
• Handle payroll adjustments, bonuses, and corrections
• Serve as the primary point of contact for nurse payroll questions
• Ensure payroll and bookkeeping records stay aligned
• Work closely with the CEO and leadership team to fully own payroll and bookkeeping, reducing leadership involvement and building reliable, scalable financial operations
• Partner with Operations and Recruiting on payroll-related needs

• Proven experience in bookkeeping or accounting
• Experience running payroll (multi-state preferred)
• Strong attention to detail and ownership mindset
• Comfortable working independently in a fast-paced, startup environment
• Clear communicator with strong organizational skills
• CPA or formal accounting certification
• Experience in healthcare or services-based businesses
• Familiarity with remote or distributed teams

• Gusto
• Quick Books
• Spreadsheets and internal dashboards

Experience with these tools is helpful, but a willingness to learn is key.

• Direct ownership and autonomy
• Minimal bureaucracy
• Flexible part-time structure with growth potential
• Opportunity to build and improve systems from the ground up
• Competitive compensation for the right candidate
• Close collaboration with company leadership and direct visibility into how the business scales
• A startup environment where good ideas are implemented quickly and ownership is earned
• Variety in day-to-day work with real opportunities to improve how the business operates

Apply now and help us build clean, reliable financial operations as we scale.