OverviewRiverView Health operates a 25 bed Critical Access Hospital, RiverView Recovery Center; a chemical dependency outpatient treatment program, RiverView Home Care and five primary care and specialty clinics in the hospitals service area.
We have a robust scholarship program for those furthering their education in a medical field, excellent benefits, and a friendly work environment. Full-time benefits include health insurance, free single vision and basic dental insurance, life insurance, long-term disability and short-term disability, and employer HSA contributions. Other benefits include employer pension matching, shift differential, incentive/premium pay, free annual biometric screening and paid volunteer time off.
Responsibilities
Chief Financial Officer (CFO)
Location: Crookston - Main Campus (on-site)
Work Status: Full-Time
Pay Range: $185,000 - $244,000 (D.O.E - dependent upon experience)
Job Status: Exempt, benefitted position
Position Overview:
The Chief Financial Officer (CFO) provides executive leadership for the financial strategy, integrity, performance, and long-term sustainability of RiverView Health.
The CFO serves as a strategic partner to the Chief Executive Officer, Board of Directors, Finance Committee, medical staff, and operational leaders. The position is accountable for finance and accounting, budgeting and forecasting, treasury and capital management, reimbursement and cost reporting, revenue-cycle performance, payer economics, and financial decision support.
The CFO translates financial and operational information into practical recommendations that support patient access, quality, workforce stability, service-line performance, and responsible stewardship of community resources.
Duties & Responsibilities: Executive Financial Leadership and Governance
- Advise the CEO, Executive Leadership Team, Board, and Finance Committee regarding financial performance, liquidity, reimbursement, risk, capital needs, strategic opportunities, and emerging industry conditions.
- Prepare and present clear, timely, and actionable financial reports, forecasts, dashboards, and recommendations.
- Participate in strategic planning, annua l goal setting, organizational performance improvement, and evaluation of affiliations, partnerships, service expansions, and major contracts.
- Promote organization-wide financial accountability by helping clinical and administrative leaders understand the effects of staffing, productivity, purchasing, documentation, charge capture, volume, and payer mix.
- Serve as the principal liaison with external auditors, financial institutions, bondholders, governmental agencies, reimbursement consultants, and other financial partners.
Finance, Accounting, and Treasury
- Direct accounting operations, including the general ledger, financial close, accounts payable, payroll accounting, fixed assets, financial reporting, and related reconciliations.
- Ensure financial statements and management reports are accurate, timely, consistent, and prepared under applicable accounting standards.
- Lead annual operating and capital budgeting, forecasting, scenario modeling, and long-range financial planning.
- Monitor performance against budget and forecast; identify material variances, underlying causes, and corrective actions.
- Oversee cash flow, liquidity, investments, banking relationships, debt obligations, financing arrangements, and applicable bond or loan covenants.
- Maintain effective internal controls, segregation of duties, financial policies, asset safeguards, and audit-ready documentation.
- Coordinate annual financial audits, tax filings, and other required financial reviews.
- Develop financial and operational performance measures appropriate to a rural healthcare organization.
Critical Access Hospital Reimbursement and Cost Reporting
- Maintain current working knowledge of CAH, Rural Health Clinic, Medicare, Medicaid, Medicare Advantage, commercial payer, and other reimbursement methodologies applicable to the organization.
- Direct or oversee preparation, review, and timely filing of Medicare and Medicaid cost reports, related workpapers, settlement estimates, and audit responses.
- Ensure accurate cost allocation, statistical reporting, expense classification, revenue-and-expense matching, and reconciliation of cost-report data to accounting and operational records.
- Evaluate how staffing, service locations, provider arrangements, charge capture, clinic designation, departmental structure, and capital decisions affect cost-based reimbursement.
- Monitor interim rates, settlements, supplemental payments, reimbursement receivables or liabilities, and payer-specific payment performance.
- Engage qualified reimbursement specialists when specialized expertise is needed while retaining executive accountability for accuracy, documentation, and organizational decisions.
Revenue-Cycle Executive Accountability
- Establish revenue-cycle strategy, policies, performance expectations, dashboards, and accountability mechanisms.
- Oversee patient access, insurance verification, authorization, financial counseling, charge capture, clinical documentation and coding interfaces, chargemaster governance, claims submission, payment posting, denials, underpayments, collections, credit balances, and patient financial services.
- Monitor meaningful indicators such as registration accuracy, authorization performance, clean-claim rate, discharged-not-final-billed days, accounts-receivable days and aging, denial rate, net cash collections, bad debt, cost-to-collect, and vendor performance.
- Ensure payer contracts and reimbursement methodologies are modeled, negotiated, implemented, and monitored appropriately.
- Sponsor interdisciplinary improvement involving Finance, Patient Access, HIM, Coding/CDI, Nursing, clinics, utilization management, IT, compliance, and operational leaders.
- Ensure patient billing and collection practices, including administration of charity care, are consistent, transparent, compliant, and respectful.
Supply Chain & Materials Management
- Provide executive oversight of procurement, sourcing, contracting, vendor negotiations, materials management, distribution, and inventory control across the organization.
- Establish standardized purchasing practices, approval authorities, competitive-bid expectations, and contract-management processes to reduce waste, duplication, and unauthorized spending.
- Implement cost-containment, product-standardization, utilization-management, and value-analysis strategies in partnership with clinical, operational, infection prevention, and finance leaders.
- Oversee supplier selection, performance, service levels, pricing, rebates, and compliance with negotiated terms; address vendor concentration, conflicts of interest, and other third-party risks.
- Maintain appropriate inventory levels, replenishment methods, storage controls, expiration monitoring, and procedures for recalls, shortages, substitutions, and emergency supplies.
- Ensure purchasing and contracting decisions account for total cost of ownership, quality and patient-safety requirements, reimbursement implications, cybersecurity and privacy risks, and operational continuity.
- Establish supply chain performance measures and reporting, including contract compliance, realized savings, inventory turns, stockouts, expired or obsolete inventory, purchase-price variance, and vendor performance.
- Coordinate supply chain priorities with annual budgeting, capital planning, service-line decisions, business continuity, and organizational emergency preparedness.
Strategic, Capital, and Service-Line Planning
- Lead financial modeling for new services, physician recruitment, partnerships, technology investments, major equipment, facilities projects, and other capital commitments.
- Evaluate existing and proposed service lines using volume, revenue, payer mix, reimbursement, capacity, labor, expense, contribution margin, community need, and operational risk.
- Develop capital plans that balance clinical need, regulatory obligations, workforce considerations, available cash, financing capacity, and long-term sustainability.
- Support responsible growth, access preservation, and evaluation of services at risk of financial or operational instability.
- Assess financial implications of emerging rural-health delivery models, grants, value-based arrangements, and collaborative opportunities.
Compliance, Risk, and Organizational Leadership
- Establish and maintain finance and revenue-cycle controls that support compliance with applicable federal, state, payer, contractual, and organizational requirements.
- Coordinate with Compliance, Legal, Quality, Privacy, IT/security, and clinical leaders; do not replace those functions’ independent professional responsibilities.
- Support organizational readiness for financial audits, payer reviews, cost-report audits, regulatory surveys, and documentation requests.
- Lead, coach, and develop assigned leaders and staff; establish clear performance expectations and succession and cross-training plans.
- Foster collaboration, ethical conduct, transparency, continuous improvement, and respectful communication.
- Remain effective during financial, operational, workforce, or community emergencies.
Qualifications
Minimum(s):
- Bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or a closely related field.
- Seven or more years of progressively responsible healthcare financial leadership experience, including at least five years in a senior finance, controller, reimbursement, revenue-cycle, or comparable leadership position.
- Demonstrated experience with hospital financial reporting, budgeting, forecasting, audit, and internal controls; Medicare and Medicaid reimbursement; Medicare cost reporting; revenue-cycle performance; cash and capital management; Board or committee presentations; and cross-functional healthcare leadership.
- Equivalent combinations of directly related education and experience may be considered where permitted by organizational policy.
Preferred(s):
- Master’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or a related discipline.
- Certified Public Accountant, HFMA certification, or another relevant healthcare-finance credential.
- Prior financial leadership in a Critical Access Hospital, rural hospital, Rural Health Clinic network, or independent community hospital.
- Experience with CAH/RHC reimbursement, cost-report strategy, payer contracting, revenue cycle, service-line analysis, provider compensation, grants, and capital financing.
- Experience leading improvement during financial strain.
Knowledge, Skills, and Competencies:
- Strategic and analytical judgment
- Financial modeling and decision support
- Integrity, discretion, and accountability
- Ability to explain complex financial concepts to non-financial audiences
- Healthcare accounting and reimbursement expertise
- Revenue-cycle and payer-contract knowledge
- Collaborative leadership and influence
- Ability to balance access, quality, workforce realities, compliance, and financial sustainability
