CFO Healthcare; path to CEO

Job Description

We're retained on a Chief Financial Officer search for a rural Critical Access Hospital in Northwest Iowa (between Omaha and Sioux City) – a Board‑appointed executive role reporting directly to the CEO, with a defined path to CEO for the right leader who wants that trajectory.

• 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

• 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)

It is an onsite role at an independent, locally governed critical access hospital and rural health delivery organization.

Our client 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 that 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 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 a 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.

• 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 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).