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

CFO & Operations Officer Opportunity

Billings Clinic is seeking a Chief Financial & Operations Officer (CFOO) to join our team. 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.

The 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 includes:

• 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

• 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
• Establish financial systems, policies, and internal controls
• Ensure compliance with GAAP, regulatory requirements, and grant/funding obligations
• Oversee cost reporting, audits, and reimbursement optimization

• 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

• 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 leaders to optimize service delivery

• Organizational Build & Start-Up Execution
• Lead development of financial infrastructure, operational policies and procedures, staffing models, and productivity benchmarks
• Support vendor selection, contracting, and implementation (e.g., EHR, outsourced services)
• Participate in construction planning, capital equipment decisions, and go-live readiness

• Team Leadership & Culture
• Recruit, develop, and lead high-performing teams
• Establish clear performance expectations and accountability structures
• Foster a culture of collaboration, transparency, and continuous improvement
• Partner with HR leadership on workforce planning and engagement

• Community & External Relationships
• Build relationships with financial institutions, auditors, regulatory agencies, community stakeholders, and partners
• Represent River Peak Health in financial and operational matters

Minimum Qualifications

Required:

• Bachelor's degree in Finance, Accounting, Business/Healthcare Administration, or related field
• 5–10+ years of progressive leadership experience in healthcare finance and/or operations
• Demonstrated experience in financial management, budgeting, and operational leadership
• Experience in Prospective Payment System (PPS) hospital or health system

Preferred:

• Master's degree (MBA, MHA, Accountancy) and/or CPA
• Experience in payer contracting and negotiation strategies
• Service line profitability and margin management
• Experience in rural healthcare settings preferred
• Prior experience in start-up, growth, or organizational build environments highly desirable

Billings Clinic is Montana's largest health system serving Montana, Wyoming, and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses, and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital, and trauma center, based in Billings, Montana.

Billings Clinic is committed to the principles of Equal Employment Opportunity. All policies and processes are designed toward achieving fair and equitable treatment of all employees and job applicants. Employees are encouraged to discuss any concerns they have in this regard with their immediate supervisor and/or the Vice President People Resources. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, creed, religion, national origin, gender, gender identity, sexual orientation, age, marital status, genetic information, or disability.