Assistant Chief Financial Officer (ACFO)

Healthcare Systems of America - Assistant Chief Financial Officer (ACFO)

Position Summary

The Assistant Chief Financial Officer (ACFO) is a senior financial leader responsible for supporting the Chief Financial Officer (CFO) in the strategic and operational management of the organization's financial functions. The ACFO oversees financial planning, budgeting, forecasting, financial reporting, revenue cycle performance, reimbursement, regulatory compliance, and operational financial analysis across the health system.

The ACFO partners with executive leadership, operational leaders, and clinical departments to improve financial performance, optimize reimbursement, ensure regulatory compliance, and support strategic initiatives while maintaining the highest standards of financial integrity.

Essential Duties and Responsibilities

Financial Leadership

• Assist the CFO in developing and executing the organization's financial strategy.
• Provide executive leadership for all finance-related operations.
• Serve as acting CFO in the CFO's absence.
• Support strategic planning, capital planning, and organizational growth initiatives.
• Present financial information to executive leadership, the Board of Directors, lenders, and external stakeholders.

Financial Planning & Analysis

• Lead the annual operating and capital budget process.
• Develop monthly forecasts, long-range financial plans, and cash flow projections.
• Analyze financial performance and identify opportunities for operational improvement.
• Develop executive dashboards and key performance indicators (KPIs).
• Perform profitability analyses by hospital, service line, physician practice, and payer.

Financial Reporting

• Oversee the preparation of monthly, quarterly, and annual financial statements.
• Ensure timely and accurate financial reporting in accordance with Generally Accepted Accounting Principles (GAAP).
• Coordinate annual audits and regulatory reporting.
• Prepare reports for executive management, lenders, and the Board.

Revenue Cycle Oversight

• Partner with Revenue Cycle leadership to improve:
  • Cash collections
  • Days in Accounts Receivable (AR)
  • Denial management
  • Clean claim rates
  • DNFB/DFNC performance
  • Net revenue realization
• Monitor reimbursement trends across Medicare, Medicaid, Managed Care, Commercial, and Self-Pay.
• Support revenue cycle transformation initiatives and system implementations.

Reimbursement & Healthcare Finance

• Oversee financial analyses related to:
  • Medicare and Medicaid reimbursement
  • Cost reports
  • Disproportionate Share Hospital (DSH)
  • Graduate Medical Education (GME)
  • Supplemental payment programs (LIP, DPP, UPL, and similar state programs)
  • Value-based reimbursement initiatives
• Analyze payer contracts and reimbursement methodologies.
• Support negotiations with managed care organizations.

Treasury & Cash Management

• Assist in managing organizational liquidity and cash flow.
• Monitor debt compliance, covenant reporting, and financing requirements.
• Develop short- and long-term cash flow forecasts.
• Partner with banking institutions and financing partners.

Compliance & Internal Controls

• Ensure compliance with all federal, state, and local regulations.
• Maintain strong internal controls and financial governance.
• Coordinate external audits and respond to audit findings.
• Ensure compliance with CMS, Medicare, Medicaid, and other healthcare reporting requirements.

Leadership

• Lead, mentor, and develop Finance and Financial Planning & Analysis (FP&A) teams.
• Foster a culture of accountability, continuous improvement, and collaboration.
• Build strong relationships with hospital executives, department leaders, physicians, and external stakeholders.

Minimum Qualifications

• Bachelor's degree in Accounting or Finance (required).
• Master's degree in Business Administration (MBA), Healthcare Administration (MHA), Finance, or related field (preferred).
• Certified Public Accountant (CPA) license required.
• Minimum of 10 years of progressive healthcare finance experience, including at least five years in a senior financial leadership role within an acute care hospital or integrated health system.
• Extensive knowledge of hospital reimbursement methodologies, revenue cycle operations, budgeting, financial reporting, and healthcare regulations.

Preferred Experience

• Multi-hospital health system experience.
• Experience with hospital acquisitions, mergers, or integrations.
• Experience managing large finance organizations.
• Experience with bond financing, lender reporting, and capital markets.
• Experience with ERP and healthcare information systems, including Meditech, Oracle, Workday, or similar platforms.
• Strong understanding of CMS reimbursement, Medicare cost reports, Medicaid supplemental payment programs, and healthcare regulatory requirements.

Knowledge, Skills & Abilities

• Strong strategic planning and financial leadership skills.
• Advanced financial modeling and analytical capabilities.
• Thorough knowledge of GAAP and healthcare accounting principles.
• Expertise in hospital reimbursement and revenue cycle operations.
• Exceptional communication and presentation skills.
• Ability to influence executive leadership and operational teams.
• Proven ability to manage multiple priorities in a fast-paced healthcare environment.
• Advanced proficiency with Microsoft Excel, financial reporting tools, and business intelligence applications.

Compensation

Competitive executive compensation package commensurate with experience, including performance-based incentives and a comprehensive benefits package.

Reporting Relationship

Reports directly to the Chief Financial Officer (CFO).