Position Overview

The Chief Financial & Operations Officer (CFOO) serves as a key member of the executive leadership team and is responsible for aligning RiverPeak Health’s financial strategy with operational execution.

This role is uniquely positioned to help build the organization from the ground up, establishing financial systems, operational infrastructure, and leadership frameworks necessary to successfully launch and sustain a high-performing rural health system.

The CFOO provides executive oversight of finance, revenue cycle, and assigned operational departments, ensuring strong financial stewardship, operational efficiency, regulatory compliance, and high-quality patient care delivery.

Reports To: Chief Executive Officer (CEO)

Position Context

RiverPeak Health is a newly developing healthcare organization with no existing operational staff at the time of hire. The CFOO will play a foundational role in:

• Building financial and operational infrastructure from inception

• Supporting recruitment and onboarding of leadership and staff

• Partnering in facility activation, service line development, and go-live readiness

• Establishing a culture aligned with RiverPeak’s mission, values, and rural community focus

Key Responsibilities

1. Executive Leadership & Strategy

• Serve as a strategic partner to the CEO, Board, and leadership team

• Participate in organizational strategic planning, business development, and growth initiatives

• Translate strategic priorities into financial and operational plans

• Support Board committees and provide regular financial and operational reporting

2. Financial Leadership

• Lead all financial functions, including:

  • Budgeting and forecasting

  • Financial reporting and analysis

  • Capital planning

  • Cash flow and treasury management

• Develop and execute financial strategies aligned with a Prospective Payment System (PPS) reimbursement environment, including optimization of case mix index, service line performance, and payer mix

• Establish financial systems, policies, and internal controls

• Ensure compliance with GAAP, regulatory requirements, and grant/funding obligations

• Oversee cost reporting, audits, and reimbursement optimization

3. Revenue Cycle & Financial Performance

• Lead financial modeling and decision-making in a fixed-reimbursement environment, ensuring sustainable margins and long-term financial viability

• Oversee revenue cycle operations, including billing, coding, collections, and payer relationships

• Monitor key financial and operational performance indicators

• Drive initiatives to improve margin, productivity, and cost efficiency

• Support payer contracting and reimbursement strategy

4. Operational Oversight

• Provide executive oversight of assigned operational departments

• Ensure alignment between clinical operations and financial performance

• Lead operational readiness efforts for facility opening (staffing, workflows, systems)

• Partner with clinical and administrative leaders to optimize service delivery

5. Organizational Build & Start-Up Execution

• Lead development of:

  • Financial infrastructure (systems, processes, reporting)

  • Operational policies and procedures

  • Staffing models and productivity benchmarks

• Support vendor selection, contracting, and implementation (e.g., EHR, outsourced services)

• Participate in construction planning, capital equipment decisions, and go-live readiness

6. Team Leadership & Culture

• Recruit, develop, and lead high-performing teams

• Establish clear performance expectations and accountability structures

• Foster a culture of collaboration, transparency, and continuous improvement

• Partner with HR leadership on workforce planning and engagement

7. Community & External Relationships

• Build relationships with:

  • Financial institutions and lenders

  • Auditors and regulatory agencies

  • Community stakeholders and partners

• Represent RiverPeak Health in financial and operational matters

Qualifications:

Required

• Bachelor’s degree in Finance, Accounting, Business/Healthcare Administration, or related field

• 5–10+ years of progressive leadership experience in healthcare finance and/or operations

• Demonstrated experience in financial management, budgeting, and operational leadership

• Experience in Prospective Payment System (PPS) hospital or health system

Preferred

• Master’s degree (MBA, MHA, Accountancy) and/or CPA

• Experience in:

  • Payer contracting and negotiation strategies

  • Service line profitability and margin management

  • Experience in rural healthcare settings preferred

  • Prior experience in start-up, growth, or organizational build environments highly desirable

Knowledge, Skills, & Abilities

• Strong financial acumen and analytical capability

• Ability to translate data into actionable insights

• Demonstrated leadership and team-building skills

• Strong communication skills with ability to engage Board, physicians, and staff

• Knowledge of healthcare reimbursement, regulatory requirements, and financial systems

• Ability to manage multiple priorities in a fast-paced, evolving environment

Working Conditions

• Primarily office-based with frequent interaction across departments

• Participation in leadership meetings, Board meetings, and community engagement

• Ability to manage competing priorities in a dynamic start-up environment

Disclaimer

This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications. Responsibilities may be adjusted as organizational needs evolve.