Chief Financial and Operations Officer; CFOO - RiverPeak Health, Riverton, WY

Join Billings Clinic

You'll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet® Recognition consecutively since 2006.

And you'll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine!

You can make a difference here.

Billings Clinic is a community-owned, not-for-profit, physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic and how we are recognized nationally for our exceptional quality.

We provide a comprehensive and competitive benefits package to all full-time employees (minimum of 24 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more.

Billings Clinic is proud to be recognized for nursing excellence as a Magnet®-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years.

We're looking for a CEOO to come join our team!

The Chief Financial & Operations Officer (CFOO) serves as a key member of the executive leadership team and is responsible for aligning River Peak 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.

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…