Job Summary:

The Chief Financial Officer (CFO) oversees all financial operations, strategy, and compliance to ensure the hospital’s fiscal health and operational efficiency while keeping the Chief Executive Officer (CEO) and the hospital Board of Directors informed of the financial condition of the hospital. The position requires availability or delegated availability to respond after working hours and to take rotational call.

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Supervisory Responsibilities:

• Direct Reports: Accounting, Accounts Payable, Materials Management, HIM, Revenue Cycle, Patient Access

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Duties/Responsibilities:

• Provide leadership to all financial departments, develop long- and short-term operational and capital budgets, and prepare cash flow and budget variance analyses. 

• Assist the CEO in strategic planning, including service demand analyses, resource availability, and cost-benefit evaluations for capital and staffing expansions.

• Ensure accurate maintenance of accounting records, oversee preparation of financial statements, internal reports, and audit work papers, and guarantee compliance with accounting standards and regulatory requirements.

• Develop a hospital budget and coordinate departmental budgets within designated deadlines according to all budgetary policies and procedures. Monitor financial performance, identify trends, and recommend budget modifications. Notify the CEO of all variances anticipated or accrued to maintain department services.

• Coordinate departmental budgets, monitor financial performance, identify trends, and recommend budget modifications. 

• Explore and recommend opportunities to reduce operating costs and increase revenue based on market trends and financial data.

• Ensure timely submission of financial reports to government and regulatory agencies, including payroll taxes, public disclosures, and third-party payor cost reports. 

• Ensure compliance with local, state, and federal laws.

• Direct finance teams, train subordinates, monitor performance, and foster collaboration across departments. 

• Maintain departmental productivity measures; report status monthly.

• Direct and participate in the development of accounting and internal control policies and systems.

• Develop and implement department policies and procedures that reflect the organization’s standards.

• Participate in the hospital’s long-and-short term financial planning process.   

• Responsible for leading all financial and treasury functions, including cost reporting and IGT drawdowns.        

• Recommend KPIs to develop a KPI dashboard and meet metrics (i.e A/R gross days to average YTD, etc).

• Assist the Clinic Administrator with Rural Health Clinic financial operations and regulatory requirements.

• Review and approve monthly balance sheet account analysis. 

• Research and apply for various grant opportunities. Monitor grant compliance to avoid overdraws or misallocations, and ensure adherence to grant terms and conditions.

• Ensure proper classification and integrity of the account balances.

• Provide timely and accurate financial reports to the CEO and Board of Directors.

• Assist in evaluating the adequacy of the hospital insurance coverage and in handling special /sensitive cases or problems and providing advice and guidance as necessary in preparing and analyzing risk management, insurance reports, and appropriate executive responsive actions.

• Participate in the analysis of financial implications of proposed capital projects and expenditures and recommend the execution of appropriate measures to respond to projected economic trends and/or regulatory changes.    

• Ensure that accurate information is provided on a timely basis and assist as needed in facilitating the efficient conduct of external audits, examinations, and related financial projects. 

• Ensure the Uncompensated Care audit is completed timely and notify Administration of any potential claw backs.

• Ensure compliance with 340B regulatory requirements and ensure completion of an annual external audit.

• Ensure compliance with price transparency and SB490.

• Perform other related duties to benefit the mission of the organization. 

Required Skills/Abilities: 

• Must be committed to quality and patient safety at all times
• Excellent command / highly proficient in spoken and written English
• Advanced computer skills, including but not limited to: Microsoft Office, information security, scheduling and payroll systems, electronic medical documentation, and email
• Must be effective at adjusting to change, prioritizing duties, handling stress, and effectively communicating face-to-face and/or over the telephone
• Must be able to work independently and flexibly, and as a part of a multidisciplinary team
• Must be able to manage several interruptions throughout the day
• Must have strong interpersonal and communication skills, verbal and written
• Must have strong time management skills
• Strong attention to detail to ensure accuracy in reporting, audits, and compliance
• Must be able to make decisions and work under pressure while interacting in a helpful, courteous manner.
• Must be able to present publicly
• Sufficient hearing, vision, and dexterity to perform duties safely

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Job-related Skills and Abilities: 

• Strong leadership, communication, and team management skills to drive performance, foster collaboration, and inspire staff. Ability to interact with diverse stakeholders, including board members, executives, and department heads
• Proficiency in financial software, data analysis, and reporting systems 
• Knowledge of healthcare reimbursement, patient billing, and cost accounting
• Must be skilled in long-term financial planning and strategic thinking 
• Ability to assess and mitigate risk
• Ability to optimize operational efficiency and financial performance
• Strong analytical and problem-solving skills
• Broad understanding of Rural Health Clinic federal regulations and reimbursement, including Medicare and Medicaid payment methodology

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Education and Experience:

• Degree in finance, accounting, or related field; advanced degrees (MBA, MHA) preferred.
• Extensive experience in healthcare finance, including budgeting, accounting, and regulatory compliance 
• Critical Access Hospital experience required.
• Meditech experience strongly preferred.

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Physical and Mental Requirements: 

• Sedentary work environment: The role is typically performed in an office setting, involving prolonged sitting at a desk for extended periods 
• Computer use: Frequent use of desktop and laptop computers, spreadsheets, and financial software (e.g., accounting systems, Microsoft Office, Project) 
• Travel: Occasional travel to meetings, conferences, or site visits may be required 
• May involve standing or walking during meetings, presentations, or board sessions.
• Occasional bending, reaching, kneeling, and lifting
• Ability to lift and carry up to 30 pounds as needed
• Frequent use of hands and fingers for computer and equipment use
• Adequate vision and hearing for communication and operational oversight
• Ability to navigate all areas of the facility
• Stress Level: Moderate to High

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OSHA Classification:

Category III: Tasks that involve no exposure to blood, body fluids, or tissues, and Category I tasks are not a condition of employment.

• The normal work routine involves no exposure to blood, body fluids, or tissues (although situations can be imagined or hypothesized under which anyone, anywhere might encounter potential exposure to body fluids). Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first-aid or to be potentially exposed in some other way. Tasks that involve handling implements or utensils, use of public or shared bathroom facilities or telephone, and personal contacts such as handshaking are Category III tasks.