Chief Financial Officer

Salary Range
$100k - $130k Annually (depending on qualifications) 
JOB SUMMARY

The Tennessee Primary Care Association (TPCA) is a 501(c)(3) nonprofit membership association representing 30 Federally Qualified Health Centers (FQHCs) and community health centers serving low-income and underserved populations across Tennessee. TPCA provides advocacy, technical assistance, training, and shared services to strengthen the capacity of its member health centers to deliver accessible, high-quality primary care.

The Chief Financial Officer (CFO) serves as TPCA's Senior Financial Executive and a key member of the Executive Leadership Team. The CFO holds primary accountability for the organization's financial health, integrity, and long-term sustainability. This includes oversight of all financial operations, federal and state grant management and compliance, budgeting and forecasting, audit management, risk management, and financial reporting to the CEO and Board of Directors.

The CFO plays a critical strategic role in supporting TPCA's growing portfolio of federal grant programs — including HRSA cooperative agreements, Innovative Health Network and the Rural Health Transformation Program (RHTP), and other federal and state funding streams and applicable program-specific regulations. The CFO partners closely with the CEO and leadership to align financial strategy with organizational priorities, advance TPCA's mission, and position the organization for sustainable growth.

As a member of the Executive Leadership Team, the CFO is entitled to a cell phone allowance and is expected to be available to senior leadership as organizational needs require.

DUTIES AND RESPONSIBILITIES

Duty 1: Provide Strategic Financial Leadership

• Serve as a trusted financial advisor to the CEO and Board of Directors; provide timely, accurate, and actionable financial intelligence to support executive decision-making and long-range planning.
• Lead the development and execution of TPCA's annual budget and multi-year financial forecasts in alignment with the organization's strategic plan, grant portfolio, and operational priorities.
• Present financial statements, budget variance analyses, cash flow projections, and financial risk assessments to the Finance Committee and full Board of Directors on a regular basis.
• Identify and evaluate emerging financial risks, funding gaps, and diversification opportunities; develop strategies to strengthen the organization's fiscal resilience.
• Advise the CEO on strategic investments, capital allocation, reserve’s policy, and the financial implications of major organizational decisions.
• Develop and maintain a financial dashboard and key performance indicators (KPIs) to monitor organizational financial health on an ongoing basis.

Duty 2: Oversee Accounting Operations and Financial Controls

• Provide support and direct oversight of all accounting functions including accounts payable, accounts receivable, payroll, general ledger, and month-end and year-end close processes.
• Ensure the accuracy and integrity of TPCA's financial records in compliance with Generally Accepted Accounting Principles (GAAP) and nonprofit accounting standards (ASC 958).
• Develop, implement, and maintain robust internal controls and financial policies and procedures to safeguard organizational assets and prevent fraud, waste, and abuse.
• Manage cash flow and banking relationships; oversee investment in operating reserves in accordance with TPCA's investment policy.
• Supervise and develop finance and accounting staff, including the Grants Administrator; foster a culture of accuracy, accountability, and continuous improvement within the finance function.
• Evaluate and maintain financial systems, accounting software, and reporting tools to ensure efficiency and scalability.

Duty 3: Lead Federal Grant Financial Management and Compliance

• Serve as TPCA's primary financial steward for all federal and state grant awards, including HRSA Health Center Program cooperative agreements, HRSA HCCN awards, RHTP grants from the Tennessee Department of Health, TIHN, and other program-specific funding.
• Ensure full compliance with 2 CFR Part 200 (Uniform Guidance), including requirements related to allowable costs, cost allocation, indirect cost rates, procurement standards, and subrecipient monitoring.
• Review and approve all grant budgets prior to submission; monitor grant expenditures against approved budgets and provide regular variance reporting to program staff and the CEO.
• Prepare and submit accurate and timely Federal Financial Reports, Payment Management System (PMS) drawdowns, and other required financial reporting to federal and state awarding agencies.
• Provide support for financial management of subgrants and subcontracts issued to member health centers; ensure subrecipient monitoring requirements are met.

Duty 4: Manage the Annual Audit and Tax Compliance

• Lead all aspects of TPCA's annual independent financial audit, including the single audit when applicable; coordinate document preparation, draft management responses to findings, and present audit results to the Finance Committee and Board.
• Ensure accurate and timely preparation and filing of TPCA's IRS Form 990 and all required state and local tax filings.
• Monitor changes in nonprofit tax law, federal grant regulations, and accounting standards; advise the CEO and Board proactively on compliance implications.
• Maintain a complete and audit-ready financial records system; ensure all financial documentation is retained in accordance with TPCA's records retention policy and federal requirements.

Duty 5: Support Contracts, Procurement, and Risk Management

• Review and provide financial analysis on all significant contracts, MOUs, and vendor agreements entered by TPCA; ensure alignment with budget and compliance requirements.
• Oversee TPCA's procurement processes to ensure compliance with federal procurement standards including competitive bidding requirements and conflict-of-interest provisions.
• Manage TPCA's organizational insurance portfolio, including general liability, directors and officers, cyber liability, and workers' compensation; ensure adequate and cost-effective coverage.
• Maintain TPCA's risk register; identify financial and operational risks and work with the CEO and Leadership Team to develop mitigation strategies.
• Ensure compliance with all applicable federal, state, and local laws and regulations governing nonprofit financial management and employment.

Duty 6: Provide Financial Technical Assistance to Member Health Centers

• Serve as a financial resource and subject matter expert to TPCA member health centers on topics including FQHC look-alike cost reporting, value-based care financial models, federal grant management, and best nonprofit financial practices.
• Develop and facilitate financial management training, webinars, and peer-learning opportunities for member health center finance staff.
• Contribute to TPCA's technical assistance portfolio by developing financial tools, templates, and resources that strengthen the financial capacity of member organizations.
• Represent TPCA in relevant state and national forums, coalitions, and workgroups related to health center finance and FQHC policy.

Duty 7: Support TPCA Team, Board Engagement, and Organizational Culture

• Actively participate as a member of the Executive Leadership Team; contribute to positive organizational culture, planning, staff development, and cross-departmental initiatives.
• Support the TPCA Finance Committee of the Board of Directors by preparing meeting materials, presenting financial reports, and responding to governance inquiries.
• Participate in TPCA staff huddles, all-staff meetings, and relevant conferences and professional development activities.
• Complete all TPCA-required administrative tasks within established timeframes, including timesheets, activity reporting, leave requests, travel authorizations, and expense reports.
• Provide staff support at Association-sponsored events and member convenings as needed.
• Perform other duties as assigned by the CEO.

MINIMUM QUALIFICATIONS

• Bachelor’s degree in accounting, Finance, Business Administration, or a related field required; Master's degree in Accounting, Finance, Business Administration (MBA), or Public Administration (MPA) preferred.
• Certified Public Accountant (CPA) designation strongly preferred.
• Minimum of seven (7) years of progressively responsible financial management experience, with at least three (3) years in a senior financial leadership role.
• Demonstrated experience managing federal grant funds in compliance including indirect cost rate development and single audit preparation.
• Nonprofit financial management experience required; experience with FQHCs, community health centers, or health-related associations strongly preferred.
• Experience presenting financial information to Boards of Directors and Finance Committees.

KNOWLEDGE, SKILLS, AND ABILITIES

• Comprehensive knowledge of nonprofit accounting standards (GAAP/ASC 958), federal grant regulations (2 CFR Part 200), and IRS requirements for 501(c)(3) organizations.
• Strong understanding of FQHC funding streams, including HRSA grants, Medicaid/TennCare cost reporting, and value-based payment models preferred.
• Exceptional analytical, financial modeling, and strategic planning skills; ability to translate complex financial data into clear, actionable insights for non-financial audiences.
• High degree of integrity, professionalism, and discretion in handling sensitive financial and organizational information.
• Strong leadership and team development skills; ability to supervise, motivate, and develop finance staff.
• Excellent verbal and written communication skills; ability to present financial information clearly to executive leadership, board members, and external stakeholders.
• Proficiency in accounting software (e.g., QuickBooks, Sage Intacct, or comparable platforms) and Microsoft Office Suite, with advanced Excel skills.
• Ability to manage multiple priorities, work independently with minimal supervision, and meet deadlines in a dynamic, mission-driven environment.
• Demonstrated commitment to health equity, cultural competence, and the mission of serving medically underserved communities.
• Knowledge of Tennessee's primary care and community health landscape a plus.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS

• Hybrid work arrangements with half office-based environment at TPCA’s Nashville, Tennessee headquarters.
• Prolonged periods of sitting, use of computer, monitor, and keyboard.
• Local, in-state, travel are required to attend site visits, conferences, funder meetings, and board meetings.
• Occasional lifting of lightweight materials (up to 25 lbs.).