Chief Financial Officer | CF

Job Description

We are retained on a Chief Financial Officer search for a rural Critical Access Hospital in Northwest Iowa (between Omaha and Sioux City). This is a Board-appointed executive role reporting directly to the CEO, with a defined path to CEO for the right leader.

• A rural CFO expanding enterprise responsibility
• A strong #2 looking to step into the top seat
• A larger-market leader ready for a change and to be part of a small team
• A Healthcare CFO/Finance executive with the goal of CEO

Location:

Onawa, Iowa – located right off I-29 between Sioux City, IA and Omaha, NE. Relocation offered.

• Sioux City, IA: 38 miles (40 mins)
• Council Bluffs, IA: 60 miles (1 hour)
• Lincoln, NE: 118 miles (1 hour 45 mins)
• Des Moines, IA: 153 miles (2 hours 25 mins)
• Kansas City, MO: 244 miles (3 hours 35 mins)

The role is onsite at an independent, locally governed critical access hospital and rural health delivery organization. It is not a municipal or county facility, nor is it owned or managed by a large health system. Decisions are made locally, leadership is visible, and the finance leader has a significant voice at the senior leadership table.

This position serves as one of three Board-appointed officers who may legally represent and act on behalf of the organization as directed by the CEO. The organization is in a planned transition phase due to a pending retirement. Core financial systems have been recently upgraded. EPIC go-live is scheduled for September. Leadership is aligned on priorities and direction. The next Vice President of Finance/CFO will provide direction and leadership going forward to optimize financial systems, work‑flows, and processes following significant new implementations and upgrades.

• Work directly with local Board finance committee and senior leadership team, no layers of system oversight
• Clear potential to impact the strategic direction and success of the organization from the CFO seat.
• Will have ample opportunity to be an "out front" visible leader, representing the organization both internally and externally as requested by the CEO
• Pathway opportunity for the right candidate who is motivated to be part of a planned CEO succession plan within 5-6 years (not required)

• Significant, core member of a 5-person, impactful senior leadership team.
• Reports directly to an experienced, collaborative highly engaged CEO.
• CEO expects the finance leader to appropriately drive discussion and offer solutions.
• Finance leadership is expected to be present, engaged and influential.

• Independent critical access hospital and rural delivery organization ($32m - $35m annual revenues)
• Comprehensive rural delivery organization with two off‑site family medicine clinics, home health, hospice, certified community mental health services and an ambulance service
• Local Board with ultimate authority (no system governance or oversight)
• Well functioning and collaborative senior team
• Modern facility, $20m renovation/expansion project completed in 2024
• Active and successful Foundation that annually supports organizational priorities
• Modern equipment due to a systematic, planned replacement program
• Typical challenges all rural healthcare facilities face with recruiting skilled workforce
• Challenges with revenue growth not keeping pace with rapidly increasing cost curve
• The need to optimize use of newly installed systems and their integration with EPIC

• Healthcare finance experience within a hospital setting
• Direct experience with cost reporting and CMS reimbursement
• Proven ability to operate in both strategic and hands‑on capacities
• Experience leading through systems change and ambiguity
• Strong communicator who builds trust across disciplines

• Experience in a Critical Access Hospital environment
• Background in healthcare-focused public accounting
• Prior CFO or senior finance leadership experience in a smaller or mid-sized hospital
• Master of Healthcare Administration (MHA) and/or National Rural Health Association Rural Hospital CFO Certification

Annual Salary

$160,000

$175,000

USD