Chief Financial Officer

Impekkable, an award-winning healthcare consulting and hospital management firm is looking for a Chief Financial Officer (CFO) to work with a hospital based in Wyoming.

• Full-time, Permanent
• Onsite in Pinedale, WY
• Relocation Assistance Provided
• Great team and organization!

JOB DETAILS

The Chief Financial Officer (CFO) serves as the senior executive responsible for the financial stewardship, strategy, and long‑term sustainability of a rural healthcare system operating as a Critical Access Hospital (CAH) with affiliated clinics, long‑term care, EMS, and related services.

As a key member of the executive leadership team, the CFO oversees all financial operations—including accounting, budgeting, reimbursement, revenue cycle, financial reporting, and internal controls—while ensuring compliance with CAH regulations and supporting The Hospital’s mission to provide high‑quality care to the community.

This role requires deep expertise in rural healthcare finance, Medicare cost‑based reimbursement, and the operational realities of managing a public healthcare entity with thin margins. The CFO is a strategic partner to the CEO and Board of Trustees and plays a critical role in sustaining and expanding healthcare services in a frontier environment.

KEY RESPONSIBILITIES

Financial Strategy & Leadership

• Develop and execute the hospitals short‑ and long‑term financial strategy aligned with organizational goals and community needs.
• Provide strategic financial direction to the CEO, Board of Trustees, and senior leadership.
• Lead enterprise forecasting, cash‑flow modeling, scenario analysis, and capital planning.
• Provide guidance on asset management, investments, and financial trends.
• Implement responsibility accounting systems, including budgeting and internal controls.
• Partner with department leaders to implement financial plans, productivity benchmarks, and performance monitoring.

Financial Reporting & Controls

• Ensure timely and accurate monthly, quarterly, and annual financial statements in accordance with GAAP and healthcare accounting standards.
• Oversee the monthly close process with a target of 5–7 business days.
• Ensure daily posting of patient and third‑party payments to patient accounts and the general ledger.
• Maintain full reconciliation of balance sheet accounts and strong internal controls.
• Present meaningful financial analyses, dashboards, and reports to the Board of Trustees.
• Monitor compliance with Group Purchasing Organization requirements.

Cost Reporting & Reimbursement

• Provide executive oversight of Medicare and Medicaid cost reports, including CAH, and long‑term care cost reports.
• Lead interim settlement modeling, rate determination, and reimbursement optimization strategies.
• Maintain strong working relationships with fiscal intermediaries (e.g., Noridian).
• Ensure compliance with CAH reimbursement methodologies, swing‑bed reimbursement, and cost‑based rules.
• Prevent revenue leakage through accurate cost reporting and reimbursement integrity.

Budgeting & Financial Planning

• Lead the annual operating and capital budgeting process (initial draft in April; final in June).
• Support department leaders with budget development, variance analysis, and financial education.
• Align budgets with strategic priorities, capital planning, and service line needs.

Audit, Compliance & Risk Management

• Oversee all financial audits, including enterprise, single audit, and long‑term care audits.
• Ensure timely audit completion to support cost reporting deadlines.
• Resolve audit findings promptly and effectively.
• Oversee bond covenant compliance, debt management, and lender reporting.
• Maintain oversight of insurance programs and renewals.
• Ensure compliance with federal, state, and healthcare regulatory requirements.

Capital Assets, Treasury & Operations Oversight

• Oversee capital asset accounting, depreciation, and inventory in accordance with AHA and GAAP standards.
• Manage banking relationships, lines of credit, and cash investments.
• Support capital project planning and financial feasibility analyses.
• Provide financial oversight for all hospital operations, including hospital services, clinics, long‑term care, EMS, and non‑healthcare assets (e.g., housing or real estate).
• Stay involved with information system conversions and financial system optimization.

Leadership & Governance

• Build and lead a high‑performing finance, accounting, and revenue cycle team.
• Promote professionalism, accountability, and continuous improvement.
• Communicate complex financial information clearly to non‑financial audiences.
• Maintain transparency and trust with the Board of Trustees and executive team.
• Serve as executive liaison with auditors, legal counsel, regulators, and external partners.

REQUIREMENTS

• Bachelor’s degree in Accounting, Finance, or Business Administration (Master’s preferred).
• CPA or CHFP preferred.
• 7–10 years of progressive healthcare finance experience, including at least 5 years in senior financial leadership.
• Strong understanding of Critical Access Hospital reimbursement, Medicare cost reports, and rural health finance.
• Experience overseeing accounting, budgeting, revenue cycle, and financial operations.
• Experience in governmental or public healthcare accounting preferred.
• Advanced proficiency with financial systems and tools (e.g., Epic, NetSuite, Microsoft Office).
• Demonstrated leadership ability with excellent communication and relationship‑building skills.
• Experience working in a rural or frontier healthcare environment.

DESIRED COMPETENCIES

• Strategic financial leadership in resource‑constrained environments.
• Strong understanding of rural health reimbursement and policy trends.
• Advanced analytical, forecasting, and problem‑solving skills.
• Collaborative leadership style with executive presence.
• High ethical standards and commitment to public stewardship.
• Ability to balance fiscal discipline with community healthcare mission.

WHY THIS ROLE MATTERS

Pinedale’s critical access hospital plays a vital role in serving a rural Wyoming community. The CFO will directly influence the hospital’s ability to sustain services, expand access, and remain financially strong in a challenging healthcare landscape.