Chief Financial Officer (CFO)
Reports to: Chief Executive Officer (CEO)
Status: Exempt, Executive Leadership
Organization: East Texas Community Clinic, Inc. A Federally Qualified Health Center (FQHC) with HRSA Health Center Program Section 330B and H80 funding
POSITION SUMMARY
Reporting to the Chief Executive Officer, the Chief Financial Officer provides strategic and operational leadership for the health center’s financial functions. The CFO ensures sound financial operations, effective forecasting and budgeting, disciplined cash and accounts payable management, strengthened revenue-cycle performance, and responsible stewardship of federal, state, foundation, corporate, and philanthropic resources.
The CFO advises executive leadership and the Board of Directors on financial strategy, sustainability, compliance, risk, and resource allocation. This role helps advance equitable access to high-quality, community-based healthcare while maintaining compliance with HRSA award terms, grant agreements, reimbursement requirements, applicable laws, and organizational policies.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Financial Strategy, Forecasting, and Reporting
Develop and maintain short- and long-term financial forecasts covering revenue, expenses, cash flow, staffing, capital needs, and operational scenarios.
Evaluate financial performance, trends, risks, and opportunities and provide recommendations to the CEO, executive team, and Board.
Prepare accurate financial statements, dashboards, variance analyses, and decision-support reports.
Ensure timely and accurate general-ledger maintenance, reconciliations, month-end close, and financial reporting.
Establish and maintain effective financial policies, procedures, approval processes, and internal controls.
Budget Development and Administration
Lead the annual operating and capital budget process in collaboration with the CEO and department leaders.
Monitor budget-to-actual results, investigate significant variances, and support corrective action plans.
Manage budget revisions, forecasts, and financial projections throughout the fiscal year.
Ensure budgets align with strategic priorities, patient-care objectives, grant conditions, and reimbursement expectations.
Revenue Cycle Oversight
Provide executive oversight of registration, credentialing, coding, billing, payment posting, denials, accounts receivable, payer performance, and collections.
Monitor key indicators including charges, collections, days in accounts receivable, denial rates, clean-claim rates, and self-pay activity.
Implement strategies to improve reimbursement, reduce preventable denials, strengthen documentation, and enhance point-of-service collections.
Partner with clinical, operational, and information-technology leaders to resolve revenue-cycle barriers and ensure payer compliance.
Accounts Payable and Cash Management
Oversee accurate, timely, authorized, and appropriately documented vendor payments.
Maintain procurement, payment, vendor-review, and segregation-of-duties controls.
Monitor daily cash position, liquidity, banking activity, and short-term funding needs.
Review significant expenditures and identify sustainable opportunities for cost control.
Maintain productive banking and vendor relationships.
Grant, Donation, and Philanthropic Funding Management
Provide executive oversight of HRSA, state, private foundation, corporate, and other grant-funded programs, together with philanthropic and individual donations.
Ensure grant and donation budgets, expenditures, revenue recognition, cost allocation, financial reports, drawdowns, reimbursements, and supporting records comply with award terms and organizational policies.
Partner with program, clinical, operational, and development leaders on applications, budgets, reporting schedules, funding restrictions, sustainability plans, and closeout activities.
Monitor restricted and unrestricted contributions, donor-imposed restrictions, pledge receivables, gift agreements, acknowledgments, and appropriate use of donated funds.
Establish procedures for allowable-cost review, matching requirements, effort documentation, indirect-cost treatment, records retention, and financial reconciliation.
Maintain a comprehensive funding calendar for applications, renewals, reporting deadlines, stewardship commitments, monitoring visits, and audits.
Evaluate the financial impact and long-term sustainability of proposed grants, contracts, gifts, sponsorships, and other commitments before acceptance.
Donor Stewardship
Partner with the CEO, development staff, and program leaders to implement a donor stewardship strategy aligned with organizational priorities and funding commitments.
Provide timely, accurate, and meaningful financial information for donor updates, stewardship reports, recognition activities, and renewal discussions.
Ensure restricted gifts are used in accordance with donor intent, gift agreements, applicable accounting requirements, and approved budgets.
Maintain reliable records of pledges, gifts, restrictions, capital campaigns, and other philanthropic commitments.
Provide the CEO and Board with reports on philanthropic revenue, donor restrictions, commitments, performance, and stewardship activities.
Support donor and foundation reviews, site visits, inquiries, audits, and other compliance or stewardship activities.
Financial Controls
Promote employee awareness of financial policies, reporting channels, ethical responsibilities, and requirements for protecting confidential financial information.
Coordinate periodic internal-control reviews, document findings, assign corrective actions, track remediation, and report significant issues to the CEO and Audit or Finance Committee.
Develop preventive and detective controls to reduce the risk of fraud, waste, abuse, conflicts of interest, errors, and misuse of organizational or restricted resources.
Establish procedures for financial access rights, system security, change management, backup, records retention, and timely removal of access for separated employees.
Monitor restricted funds and cost-center activity to confirm expenditures are allowable, accurately coded, properly allocated, and consistent with funding-source requirements.
Ensure journal entries, estimates, allocations, write-offs, and adjustments are supported, independently reviewed, and appropriately approved.
Oversee vendor setup, change controls, invoice validation, duplicate-payment prevention, payment authorization, and periodic vendor-master reviews.
Implement controls over cash, credit cards, purchasing cards, checks, electronic payments, refunds, petty cash, and other financial instruments.
Ensure routine reconciliations of bank accounts, accounts receivable, accounts payable, payroll, grants, donations, deferred revenue, restricted funds, and balance-sheet accounts.
Maintain clear approval thresholds and delegations of authority for expenditures, contracts, purchasing, payroll, grants, donations, journal entries, and cash disbursements.
Establish appropriate segregation of duties for authorization, custody, recording, reconciliation, and review of financial transactions.
Design, implement, document, and periodically assess a comprehensive system of financial controls that protects organizational assets and supports accurate, reliable reporting.
Compliance, Audit, and Internal Controls
Maintain financial practices consistent with applicable federal, state, and local requirements, HRSA award conditions, grant agreements, and Uniform Guidance where applicable.
Support financial audits, single audits, cost reports, tax filings, and required submissions.
Coordinate audit responses and oversee implementation of corrective actions.
Promote appropriate controls to prevent fraud, waste, abuse, material misstatement, and misuse of restricted funds.
Ensure adequate documentation and records retention for financial transactions and sponsored programs.
Executive Leadership
Serve as a member of the executive leadership team and contribute to strategic planning and organizational decisions.
Provide financial guidance for service expansion, grants, contracts, capital projects, workforce planning, and operating initiatives.
Lead, coach, and develop finance personnel while establishing clear goals and performance expectations.
Communicate complex financial information clearly to nonfinancial audiences and maintain effective relationships with auditors, funders, banks, vendors, and regulators.
Work Requirements
This position primarily involves office-based, computer-intensive work and regular participation in executive, finance, leadership, Board, and committee meetings. Occasional travel, community engagement, and work outside standard business hours may be required.
Equal Employment Opportunity Statement
The health center provides equal employment opportunities in accordance with applicable law. Employment decisions are based on qualifications, organizational needs, and job-related criteria without unlawful discrimination. The organization is committed to an inclusive workplace and to treating patients, donors, funders, and employees with respect and dignity.
Disclaimer
This job description summarizes the principal responsibilities and qualifications of the position. It is not an exhaustive list of all duties. Responsibilities may be adjusted based on organizational needs, HRSA requirements, funding agreements, and applicable regulatory changes.
Minimum Qualifications
Bachelor’s degree in finance, accounting, business administration, healthcare administration, or related field.
Progressive financial leadership experience, preferably in healthcare, an FQHC, community health center, nonprofit, or other mission-driven organization.
Demonstrated experience with forecasting, budgeting, accounts payable, revenue-cycle operations, grant-funded activities, and philanthropic resources.
Experience preparing and interpreting financial statements, budgets, forecasts, and executive-level reports.
Knowledge of healthcare reimbursement, payer requirements, cost allocation, internal controls, grant compliance, audits, and restricted-fund stewardship.
Ability to lead teams, manage competing priorities, and communicate effectively with executives, clinicians, employees, and the Board.
Preferred Qualifications
Master’s degree in business administration, healthcare administration, finance, or related discipline.
CPA, CMA, or other relevant professional credential.
Experience with HRSA Health Center Program Section 330 funding and H80 reporting or related health center award requirements.
Experience with Medicaid, Medicare, FQHC reimbursement, state grants, private foundation awards, corporate contributions, and donor-restricted funds.
Experience with nonprofit accounting, Uniform Guidance, grant proposals, funder budgets, stewardship reporting, and sustainability planning.
Experience implementing financial systems, automated workflows, dashboards, and performance-improvement initiatives.
Knowledge, Skills, and Abilities
Strategic financial planning and analysis.
Healthcare revenue-cycle management.
Federal, state, foundation, corporate, and donor-funded accounting.
Cash-flow planning and expense management.
Audit coordination, compliance monitoring, and risk management.
Financial systems, reporting tools, and data-driven decision-making.
Executive communication, presentation, negotiation, and problem-solving.
Commitment to the health center’s mission and service to underserved communities.
