Chief Financial Officer (CFO) - Critical Access Hospital

Chief Financial Officer (CFO)

Department: Administration
Status: Full-Time | 1.0 FTE
FLSA Status: Exempt
Schedule: 40+ hours/week
Reports To: Chief Executive Officer
Location: Pagosa Springs Medical Center – Pagosa Springs, Colorado

🏥 Position Highlight

Provide strategic financial leadership for a rural Critical Access Hospital and help ensure the long-term sustainability of essential healthcare services in southwest Colorado.

As a member of Pagosa Springs Medical Center's Executive Leadership team, the Chief Financial Officer will shape financial strategy across our Critical Access Hospital, Rural Health Clinic, and Emergency Medical Services operations, partnering closely with the CEO, Board of Directors, clinical leaders, and operational leaders to strengthen financial performance while supporting high-quality patient care.

Position Summary

Pagosa Springs Medical Center (PSMC) is seeking an experienced and forward-thinking Chief Financial Officer (CFO) to serve as a senior executive leader responsible for the financial strategy, performance, sustainability, and financial integrity of the Medical Center.

The CFO provides strategic and operational financial leadership across PSMC's Critical Access Hospital (CAH), Rural Health Clinic (RHC), and Emergency Medical Services (EMS) operations. This role is responsible for ensuring organizational leaders have the financial information, education, and support necessary to make informed decisions and understand their role in achieving the Medical Center's financial goals.

This position extends well beyond traditional financial reporting. The CFO serves as an active strategic and operational partner to the CEO and other senior leaders, using financial and operational data to identify trends, anticipate risks, evaluate opportunities, strengthen revenue performance, and support the long-term financial sustainability of PSMC and the essential healthcare services we provide.

Key areas of executive responsibility include financial strategy and service-line analysis, revenue cycle leadership, payer contracting and reimbursement, budgeting and financial planning, accounting and financial reporting, Medicare cost reporting, and management financial education and accountability.

Why Join PSMC?

• Serve as a key executive leader for an independent rural Critical Access Hospital
• Influence the long-term financial strategy and sustainability of healthcare services for our community
• Oversee financial strategy across hospital, Rural Health Clinic, and EMS operations
• Partner directly with the CEO, Board of Directors, Executive Leadership, clinical leaders, and operational leaders
• Lead organization-wide revenue cycle strategy, from patient access and charge capture through billing, denials, collections, and reimbursement
• Guide payer strategy and reimbursement analysis in a complex Medicare, Medicaid, and commercial payer environment
• Lead financial analysis for existing and proposed service lines to support informed growth decisions
• Bring financial information to life by helping managers and clinical leaders understand how operational decisions affect organizational performance
• Join a mission-driven healthcare organization where financial stewardship directly supports continued access to local healthcare

Key Responsibilities

Financial Strategy & Service-Line Analysis

• Provide forward-looking financial leadership that supports organizational strategy, patient care, and long-term sustainability
• Evaluate the financial performance and sustainability of existing service lines using volume, revenue, payer mix, reimbursement, expense, contribution margin, capacity, and other operational data
• Develop comprehensive pro forma analyses for proposed new or expanded services
• Incorporate quality metrics into financial analysis to connect clinical outcomes with financial performance
• Evaluate market share, saturation, and relevant external operational metrics
• Identify opportunities to improve performance, increase revenue, reduce expense, and better meet the healthcare needs of the community
• Partner with senior leaders in developing service lines that support PSMC's long-term sustainability

Revenue Cycle Leadership

• Provide executive oversight of the full revenue cycle
• Ensure effective coordination among clinical, operational, and revenue cycle functions
• Oversee payer contracting, chargemaster integrity, charge capture and reconciliation, patient access and registration, eligibility and authorization, coding, billing, claims management, denials, collections, and overall revenue cycle performance
• Strengthen front-end accuracy, including insurance eligibility verification and pre-authorization
• Support clinical documentation and coding integrity throughout the middle revenue cycle
• Monitor back-end performance, including days in accounts receivable, cash posting, claims performance, and third-party vendors
• Develop strategies to respond to changing payer requirements and restrictions
• Ensure appropriate auditing of claims to reduce unbilled services and documentation-related revenue leakage

Payer Contracting & Reimbursement

• Evaluate payer contracts, reimbursement methodologies, and the financial implications of contract terms
• Ensure PSMC has the data and analytical capabilities necessary to understand reimbursement performance
• Identify reimbursement opportunities and financial risks
• Analyze organizational cost structures when evaluating payer rates
• Continuously monitor payer contract performance
• Evaluate and monitor discounted care programs for compliance and accurate reporting

Budgeting & Financial Planning

• Lead development of PSMC's annual operating and capital budgets
• Establish realistic assumptions for patient volumes, revenues, reimbursement, staffing, compensation, operating expenses, capital needs, and organizational growth
• Monitor short-term liquidity necessary to meet payroll and vendor obligations
• Ensure revenue projections appropriately account for Medicare, Medicaid, commercial insurance, and other payer sources
• Utilize financial performance KPIs and efficiency indicators in organizational planning
• Forecast capital, technology, staffing, and operational needs
• Monitor budget performance and initiate corrective action when appropriate

Accounting & Financial Reporting

• Provide leadership and oversight of PSMC's finance and accounting functions
• Ensure accurate and timely monthly financial statements
• Maintain appropriate financial controls
• Oversee cash management and forecasting
• Support and actively participate in required audit processes
• Present meaningful financial information to senior leadership, the Finance Committee, and Board of Directors
• Ensure accurate financial reporting related to grants and contributions

Critical Access Hospital & Medicare Cost Reporting

• Maintain strong working knowledge of Medicare reimbursement and cost reporting requirements applicable to a Critical Access Hospital and Rural Health Clinic
• Understand how staffing, operations, service lines, cost allocation, and other financial decisions affect Medicare cost reporting and reimbursement
• Incorporate CAH reimbursement implications into organizational financial and operational decision-making
• Ensure accurate expense tracking and appropriate cost allocation
• Ensure required Medicare cost reporting is accurate and timely
• Oversee timely submission of CMS Form 2552-10 following the close of PSMC's fiscal year

Executive Leadership & Strategic Planning

• Serve as a strategic and operational partner to the CEO and Executive Leadership team
• Participate with the Board and Executive Leadership in establishing annual strategic and operational goals
• Develop short- and long-term financial plans aligned with PSMC's mission and strategic plan
• Identify opportunities for responsible growth and service expansion
• Translate organizational priorities into measurable action and results
• Lead organizational change in a positive and productive manner
• Use data, operational insight, and frontline input to identify challenges, implement solutions, and measure results
• Remain effective during emergencies, staffing shortages, operational disruptions, and other high-pressure situations

Financial Education & Accountability

• Translate complex financial and revenue cycle information into practical, understandable information for managers and clinical leaders
• Educate leaders on how staffing, productivity, scheduling, purchasing, charge capture, documentation, patient volumes, and service delivery affect revenue, expense, reimbursement, and overall financial performance
• Provide financial education to the Board regarding financial metrics, cash flow trends, and compliance responsibilities
• Establish clear expectations and promote financial accountability throughout the organization

Leadership & People Development

• Lead and develop assigned managers, directors, and staff
• Establish clear expectations for performance, training, professional development, conduct, and accountability
• Foster a positive, collaborative, high-performing culture
• Provide coaching, feedback, and performance management in a fair and consistent manner
• Support staff development, education, and cross-training
• Oversee recruitment, interviewing, selection, onboarding, and retention within assigned areas in partnership with Human Resources
• Promote open communication and ensure organizational priorities are effectively communicated to staff
• Build effective relationships across clinical, administrative, executive, Board, and community stakeholders

Compliance & Governance

• Ensure compliance with applicable federal, state, and local requirements, including requirements applicable to Critical Access Hospital operations
• Maintain readiness for regulatory and licensing surveys
• Monitor compliance with organizational policies and procedures
• Support appropriate development and maintenance of departmental policies
• Maintain confidentiality and compliance with applicable privacy requirements
• Participate in executive, Board, Finance, Strategic Planning, Facilities, Governance, Emergency Management, Revenue Cycle, Utilization Management, Compliance, and other assigned meetings and committees