Account architecture
Ad groups themed by buying intent, not by whatever the previous agency left behind. In healthcare that meant seven themes — Outpatient, Residential, Detox, Insurance, DUI — each with its own copy and landing page.
Google Ads
management.
Search accounts structured around what people actually intend to do, bid against revenue rather than clicks, and measured on conversions you can trust.
Most underperforming Google Ads accounts are not badly optimised. They are optimised correctly toward the wrong number — a conversion action that fires on a page view, a lead form counted twice, phone calls nobody is attributing.
So the first week is spent on the measurement layer, not the bids. Once the account is reporting the truth, the structural work has something honest to optimise against: themed ad groups by intent, search-term hygiene, bid strategies set on unit economics, and creative testing that runs long enough to mean something.
This is hands-on management by the person who built the account — not a dashboard and a monthly PDF.
01 — What's included
What you actually get.
Conversion tracking
GA4 and Google Ads conversion imports, offline conversion uploads where the sale closes off-site, and call tracking through CallRail or CallTrackingMetrics.
Bidding on unit economics
Target CPA and ROAS strategies fed with real margin data, so the algorithm optimises toward profit instead of volume.
Search term discipline
Weekly negative keyword work and match-type control. Broad match without supervision is how budgets disappear.
Creative & RSA testing
Responsive search ads tested against pinned control variants, plus structured tests of newer formats like AI Max against manual builds.
Reporting you'll read
A one-page scorecard: spend, conversions, cost per lead, and what changed. Ninety seconds, not thirty slides.
02 — Proof
Numbers from real accounts.
From a US addiction-treatment search account — one of the most regulated and expensive verticals in paid search, where clicks run $8–9.
$117KManaged spend
7.56%Conversion rate
1,051Conversions
$112Cost per lead
~3.5×Approx. ROAS
343KImpressions
03 — How it runs
The order
matters.
Buying against a broken signal just spends the budget faster, so the measurement work always comes first.
Get a free account review →-
01
Audit the measurement layer
GA4, Tag Manager, conversion imports, call tracking. Before a single bid changes, the numbers the account optimises toward have to be true.
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02
Restructure by intent
Rebuild ad groups around what searchers want, so copy and landing pages can actually match the query.
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03
Test deliberately
One structural change at a time, run to significance. Testing three things at once tells you nothing about any of them.
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04
Scale without drift
Push daily spend to find the volume ceiling while holding cost per acquisition steady.
04 — Questions
Before you ask.
What ad spend do you usually work with?
Accounts from a few thousand dollars a month up to six figures a year in managed spend. Below roughly $2,000 a month there usually isn't enough data to test properly, and you're better off with a one-off audit than ongoing management.
Do you rebuild the account or work with what's there?
Whichever costs less to get right. If the structure is sound and the tracking is broken, fixing the tracking often recovers more performance than a rebuild. If the account is a single ad group with 400 keywords, it gets rebuilt.
Will I own the account?
Yes. The Google Ads account stays in your name with your billing attached. I work inside it with access you can revoke. Anything I build in it is yours if we stop working together.
Want this pointed
at your account?
Send over the account, the vertical, and what's not working. You'll get a reply within two working days and the first two things I'd change — free, whether or not you hire AQM.