Chief Financial Officer

Job Description

Job Description

This job is posted on behalf of The Exeter Group by Top Echelon.

Our client is a mission-driven, patient-centered Federally Qualified Health Center (FQHC) delivering comprehensive primary care, behavioral health, and enabling services to a diverse and underserved population. As a Health Resources and Services Administration-designated health center operating under Section 330 of the Public Health Service Act, our client serves as a critical safety-net provider, ensuring access to high-quality, equitable care regardless of a patient’s ability to pay.

With a workforce of approximately 250 employees and an annual operating budget of $44 million, the organization is advancing a deliberate strategy focused on financial sustainability, operational rigor, and long-term community impact. Key priorities include strengthening core infrastructure, expanding value-based care arrangements to align reimbursement with outcomes, and optimizing participation in the 340B Drug Pricing Program to reinvest resources into patient care. Through this integrated approach, our client is positioned to sustain and scale mission-critical services for the communities it serves well into the future.

The Chief Financial Officer (CFO) is a strategic executive leader responsible for the full financial health, sustainability, and compliance of the organization. Reporting directly to the CEO and serving as a key member of the Executive Leadership Team, the CFO provides visionary financial stewardship while ensuring operational excellence across all finance functions — including revenue cycle management, budgeting and forecasting, grant accounting, 340B program oversight, and value-based care financial modeling. 

Responsibilities

• Serve as a trusted strategic advisor to the CEO, Board of Directors, and Executive Leadership Team on all financial matters, modeling and articulating the financial implications of organizational decisions. 
• Lead the development and execution of a multi-year financial strategy aligned with the organization's mission, growth priorities, and community health goals. 
• Ensure financial sustainability and resilience, including maintaining adequate reserves, managing cash flow, and positioning the organization for capital investment. 
• Present comprehensive financial reports and analyses to the Board Finance Committee and full
• Provide executive oversight of the entire revenue cycle — from patient registration and eligibility verification through charge capture, coding, billing, claims submission, and collections. 
• In partnership with outsourced billing provider, establish and monitor key performance indicators (KPIs) for revenue cycle performance, including days in A/R, denial rates, clean claim rates, and net collection ratios. 
• Drive continuous improvement initiatives to optimize billing processes, reduce denials, and accelerate cash collections across all payer mixes — including Medicaid, Medicare, commercial insurance, sliding fee scale, and grant-funded services. 
• Ensure compliance with FQHC prospective payment system (PPS) billing requirements and HRSA reporting standards. 
• Oversee coding accuracy and compliance, collaborating with clinical leadership to ensure documentation supports appropriate reimbursement. 
• Lead the organization-wide annual budget development process in close partnership with department directors, the CEO, and the Board, ensuring alignment of resources with strategic priorities.
• Deliver timely and accurate monthly, quarterly, and annual financial statements, budget variance analyses, and rolling forecasts.
• Develop sophisticated financial models to evaluate new programs, service lines, facility expansions, and strategic partnerships.
• Develop and maintain value-based care financial models and contract analyses, including projections for shared savings, risk corridors, quality bonus payments, and total cost of care performance across all VBC arrangements; integrate VBC financial performance into the annual budget and multi-year financial planning cycles.
• Maintain and continuously improve internal financial controls and accounting policies consistent with GAAP, HRSA requirements, and federal cost principles.
• Oversee financial management of all federal, state, and foundation grants — including HRSA Section 330 and other funding streams — ensuring strict compliance with grant terms, allowable cost standards, and reporting requirements. 
• Manage the annual Single Audit process, serving as the primary liaison with external auditors and ensuring timely, clean audit outcomes. 
• Develop and maintain cost allocation methodologies that accurately distribute shared costs across funding sources and programs. 
• Provide proactive financial guidance to program directors on grant expenditures, period of performance management, and closeout requirements. 
• Support the development and submission of grant budgets and budget justifications in coordination with the Development team and CEO. 
• Provide executive leadership and oversight of the organization's 340B Drug Pricing Program, ensuring full compliance with HRSA OPAIS requirements, including patient eligibility, covered entity status, and contract pharmacy oversight. 
• Work closely with the 340B Coordinator, TPA’s, pharmacy partners, and clinical leadership to maximize 340B savings while maintaining rigorous compliance safeguards. 
• Monitor 340B program performance, including savings capture rates, split-billing accuracy, and audit readiness. 
• Stay current on HRSA 340B guidance, regulatory changes, and emerging compliance risks; implement policy updates as needed. 
• Ensure accurate financial reporting of 340B savings and reinvestment to support mission-driven programs and services. 
• Lead the financial strategy for the organization's participation in value-based care (VBC) arrangements, including Accountable Care Organizations (ACOs), Medicaid managed care risk contracts, and quality incentive programs. 
• Develop and maintain financial models to evaluate VBC contract performance, shared savings/risk projections, quality bonus achievement, and total cost of care targets. 
• Collaborate with clinical operations, quality, and informatics teams to align financial incentives with clinical performance improvement and population health outcomes. 
• Evaluate and manage financial risk exposure under downside-risk VBC arrangements; develop contingency plans and risk mitigation strategies. 
• Monitor state and federal policy developments in value-based payment, Medicaid Alternative Payment Models (APMs), and CMS innovation models. 
• Build, develop, and inspire a high-performing finance team — including accounting, billing, and financial analysis staff — creating a culture of accountability, professional growth, collaboration, and continuous learning.
• Foster cross-functional partnerships across clinical, operations, human resources, and program departments, ensuring finance is seen as a strategic enabler — not just a compliance function. 
• Model inclusive, equity-centered leadership consistent with the organization's values and commitment to health equity. 
• Mentor and develop finance staff at all levels, building depth and succession capacity within the department.
• Actively participate in the Executive Leadership Team, contributing to organization-wide strategic planning, workforce decisions, and operational problem-solving. 

Education and Experience:

• Bachelor's degree in Accounting, Finance, Business Administration, or a closely related field. 
• Minimum of 7 years of progressive financial management experience, with at least 5 years in a senior finance leadership role (CFO,VP of Finance, or equivalent). 
• Demonstrated experience in FQHC, Federally Qualified Health Center Look-Alike (FQHCA), or community health center finance. 
• Proven expertise in healthcare revenue cycle management, including Medicaid/Medicare billing and FQHC PPS reimbursement. 
• Hands-on experience with federal grant accounting and Single Audit compliance. 
• Working knowledge of 340B Drug Pricing Program compliance requirements and operations. 
• Experience in value-based care financial modeling and managed care contract analysis. 
• Exceptional leadership, communication, and interpersonal skills with a track record of developing high-performing teams. 
• High degree of integrity, professional judgment, and commitment to transparency
• Master’s degree in business administration (MBA), Health Administration (MHA), or Accounting/Finance.  
• Certified Public Accountant (CPA) or Certified Healthcare Financial Professional (CHFP). 
• Experience with HRSA Uniform Data System (UDS) reporting and HRSA site visit preparation. 
• Familiarity with electronic health record (EHR) and practice management systems (e.g., eClinicalWorks, NextGen, athenahealth). 
• Experience presenting to nonprofit Boards of Directors or Board Finance Committees. 
• Demonstrated commitment to health equity and experience in safety-net or community health setting

This job description is designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties and responsibilities required of employees assigned to this job.  

Our client is an equal opportunity employer and does not discriminate based on race, religion, gender, age, sexuality, or gender identification.