Job Description

The Chief Financial Officer (CFO) -Fairfield Hospital is a key member of the executive leadership team, responsible for the strategic oversight and operational execution of all financial functions of the hospital. This role requires a high degree of professional judgment, confidentiality, and technical expertise.

The CFO ensures the integrity of financial systems, maintains strong internal controls, and leads the development of accurate, timely, and meaningful financial reporting. This leader directs the hospital’s Critical Access Hospital (CAH) cost report strategy, ensuring reimbursement opportunities are maximized and all financial decisions align with federal and state regulatory requirements—including CMS CAH Cost Report preparation and submission.

This position plays a central role in financial turnaround efforts, including expense restructuring, service line profitability analysis, scenario modeling, and long-range financial forecasting. The CFO also oversees contract evaluation, capital planning, financial risk assessment, and revenue cycle performance.

In addition to technical leadership, the CFO provides strong people leadership—developing staff capabilities, strengthening financial processes, and fostering a culture of accountability, performance, and continuous improvement across all financial and revenue cycle functions.

Essential Duties & Responsibilities

Cash Flow & Liquidity Management

• Provide executive leadership for cash flow strategy to support operational stability and long-term sustainability
• Oversee weekly cash forecasting, monitoring liquidity needs, reimbursement timing, and financial risk indicators
• Implement burn rate reduction strategies, optimizing spend and aligning cash outflows with organizational priorities
• Maintain strong banking relationships and ensure timely fulfillment of financial obligations

Revenue Cycle Ownership

• Provide executive oversight of the full revenue cycle, including patient access, billing, coding, denials management, collections, and cash posting
• Drive KPI-based performance across AR > 90 days, DNFB, denial rates, and cash collections
• Identify and resolve systemic reimbursement issues in collaboration with clinical and operational leaders
• Ensure revenue cycle operations support financial performance and regulatory compliance

Cost Report & Reimbursement Strategy

• Lead the hospital’s CAH reimbursement strategy with a strong cost report focus
• Oversee the preparation, accuracy, and timely submission of the annual CMS CAH Cost Report and all supporting documentation
• Provide quarterly reimbursement projections, including interim settlements and cost-based reimbursement impacts
• Evaluate all capital, operational, and service line decisions through a cost report lens to maximize reimbursement and sustainability

Financial Turnaround Execution

• Lead financial turnaround initiatives, including expense restructuring and operational efficiency improvements
• Conduct service line profitability analysis and implement corrective action plans
• Develop scenario models and pro forma financials to support strategic decision-making
• Provide financial leadership during periods of organizational change and reimbursement pressure

Financial Reporting & Analysis

• Ensure the accuracy, integrity, and timeliness of all financial statements and reports
• Direct the monthly close process, including reconciliations across all key accounts
• Analyze financial results, explain variances, and provide actionable recommendations
• Deliver decision-ready reporting to leadership, the CEO, and the Board

Compliance, Controls & Regulatory Oversight

• Maintain strong internal controls in compliance with GAAP, CMS, and Medicare/Medicaid requirements
• Ensure adherence to all federal and state billing and reimbursement regulations
• Oversee accurate accounting and statistical recordkeeping for reimbursement programs
• Ensure audit readiness and ongoing regulatory compliance

Contracting & External Relationship Management

• Evaluate and oversee general contracts, managed care agreements, participation agreements, leases, reagent rental agreements, and capital purchases
• Serve as the hospital’s authorized signatory for contractual agreements unless otherwise directed by the CEO
• Maintain relationships with auditors, vendors, payors, financial institutions, and regulatory partners
• Advise leadership on financial implications of contract terms and reimbursement structures

Leadership, Culture & Staff Development

• Lead and develop finance, accounting, and revenue cycle teams
• Foster a performance-driven culture rooted in accountability, accuracy, and continuous improvement
• Provide coaching and mentorship to strengthen staff competency in GAAP, reimbursement, and financial systems
• Align departmental goals with organizational strategy and KPIs

Budgeting, Forecasting & Capital Planning

• Lead development of annual operating and capital budgets aligned with strategic priorities
• Provide financial projections, feasibility studies, and investment analyses
• Evaluate capital requests based on cost, reimbursement impact, and long-term return
• Support leadership in prioritizing investments and managing financial risk

Systems, Processes & Operational Optimization

• Oversee implementation and optimization of accounting and patient accounting systems
• Evaluate workflows and implement process improvements to enhance efficiency and controls
• Ensure systems support accurate reporting and strong revenue cycle performance

Executive Advisory & Organizational Impact

• Advise the CEO, Board, and leadership team on financial implications of decisions and market conditions
• Provide insight into service line development, capital planning, and growth strategy
• Ensure leadership understands reimbursement impacts tied to operational decisions

Minimum Qualifications

• Bachelor’s degree in Accounting, Finance, Business Administration, or related field
• 7–10 years of progressive healthcare finance experience, including accounting, reimbursement, and revenue cycle operations

Preferred Qualifications

• Master’s degree in Accounting, Finance, Healthcare Administration, or related field
• CPA, CMA, or equivalent certification
• 10–15 years of healthcare finance experience with 5+ years in a senior leadership role (Controller, Director of Finance, VP Finance)
• Experience in Critical Access Hospital finance, cost report modeling, financial turnaround environments, and system implementation

Knowledge, Skills & Abilities

Financial & Technical Expertise

• Deep knowledge of GAAP, CMS regulations, Medicare/Medicaid reimbursement, and CAH cost-based methodologies
• Strong command of revenue cycle operations and KPI-driven performance
• Proficiency in financial modeling, forecasting, and service line profitability analysis

Strategic & Operational Leadership

• Ability to lead cash flow stabilization and liquidity management strategies
• Skill in aligning financial decisions with reimbursement and cost report impact
• Experience driving financial turnaround and operational efficiency initiatives

Analytical & Decision-Making

• Ability to interpret complex financial data and provide actionable insights
• Strong evaluation skills for capital planning, contracts, and financial risk
• Expertise in delivering accurate, decision-ready reporting

Leadership & Communication

• Proven ability to lead high-performing teams
• Strong communication skills with executives, Board members, and operational leaders
• High level of integrity, confidentiality, and professional judgment

Deaconess Health System is the premier provider of health care services to 51 counties in three states (IN, IL, and KY). The system consists of 18 wholly owned, joint ventured, sponsored or affiliated hospitals located in southern Indiana, southeastern Illinois and western Kentucky.

Fairfield Memorial Hospital is a fully-accredited, not-for-profit critical access hospital. It has 25 acute-care beds and employs more than 250 employees. The medical staff at FMH is made up of more than 90 credentialed physicians and healthcare providers. It is accredited by the Joint Commission. FMH offers a number of services including a 30-bed Skilled Care Unit, Home Health Services, 24-hour emergency care, ICU, surgical services, diagnostic imaging, pulmonary and cardiac rehab and occupational, speech and physical therapies. FMH opened Horizon Healthcare in 2008, a certified hospital based-rural health clinic. It is now housed in a 25,486 square foot facility in Fairfield and has two other locations as well.