Chief Financial Officer

Impekkable, an award-winning healthcare consulting and hospital management firm is looking for a Chief Financial Officer (CFO) to work with a hospital based in Wyoming.

• Full-time, Permanent
• Onsite in Pinedale, WY
• Relocation Assistance Provided
• Great team and organization!

The Chief Financial Officer (CFO) serves as the senior executive responsible for the financial stewardship, strategy, and long‑term sustainability of a rural healthcare system operating as a Critical Access Hospital (CAH) with affiliated clinics, long‑term care, EMS, and related services.

As a key member of the executive leadership team, the CFO oversees all financial operations—including accounting, budgeting, reimbursement, revenue cycle, financial reporting, and internal controls—while ensuring compliance with CAH regulations and supporting The Hospital’s mission to provide high‑quality care to the community.

This role requires deep expertise in rural healthcare finance, Medicare cost‑based reimbursement, and the operational realities of managing a public healthcare entity with thin margins. The CFO is a strategic partner to the CEO and Board of Trustees and plays a critical role in sustaining and expanding healthcare services in a frontier environment.

Financial Strategy & Leadership

• Develop and execute the hospitals short‑ and long‑term financial strategy aligned with organizational goals and community needs.
• Provide strategic financial direction to the CEO, Board of Trustees, and senior leadership.
• Lead enterprise forecasting, cash‑flow modeling, scenario analysis, and capital planning.
• Provide guidance on asset management, investments, and financial trends.
• Implement responsibility accounting systems, including budgeting and internal controls.
• Partner with department leaders to implement financial plans, productivity benchmarks, and performance monitoring.

Financial Reporting & Controls

• Ensure timely and accurate monthly, quarterly, and annual financial statements in accordance with GAAP and healthcare accounting standards.
• Oversee the monthly close process with a target of 5–7 business days.
• Ensure daily posting of patient and third‑party payments to patient accounts and the general ledger.
• Maintain full reconciliation of balance sheet accounts and strong internal controls.
• Present meaningful financial analyses, dashboards, and reports to the Board of Trustees.
• Monitor compliance with Group Purchasing Organization requirements.

Cost Reporting & Reimbursement

• Provide executive oversight of Medicare and Medicaid cost reports, including CAH, and long‑term care cost reports.
• Lead interim settlement modeling, rate determination, and reimbursement optimization strategies.
• Maintain strong working relationships with fiscal intermediaries (e.g., Noridian).
• Ensure compliance with CAH reimbursement methodologies, swing‑bed reimbursement, and cost‑based rules.
• Prevent revenue leakage through accurate cost reporting and reimbursement integrity.

Budgeting & Financial Planning

• Lead the annual operating and capital budgeting process (initial draft in April; final in June).
• Support department leaders with budget development, variance analysis, and financial education.
• Align budgets with strategic priorities, capital planning, and service line needs.

Audit, Compliance & Risk Management

• Oversee all financial audits, including enterprise, single audit, and long‑term care audits.
• Ensure timely audit completion to support cost reporting deadlines.
• Resolve audit findings promptly and effectively.
• Oversee bond covenant compliance, debt management, and lender reporting.
• Maintain oversight of insurance programs and renewals.
• Ensure compliance with federal, state, and healthcare regulatory requirements.

Capital Assets, Treasury & Operations Oversight

• Oversee capital asset accounting, depreciation, and inventory in accordance with AHA and GAAP standards.
• Manage banking relationships, lines of credit, and cash investments.
• Support capital project planning and financial feasibility analyses.
• Provide financial oversight for all hospital operations, including hospital services, clinics, long‑term care, EMS, and non‑healthcare assets (e.g., housing or real…