Hospice of Davidson County North Carolina Inc.
Chief Financial Officer
Hospice of Davidson County North Carolina Inc., Lexington, North Carolina, United States, 27292
Position Description
Chief Financial Officer (CFO)
Primary Function
The Chief Financial Officer (CFO) provides leadership and oversight of all financial management functions at Hospice of Davidson County (Agency). This position reports to the Chief Administrative Officer (CAO) and is indirectly supervised by the Chief Executive Officer (CEO). The CFO has a dotted-line reporting relationship to the CEO.
The CFO develops and implements the Agency's financial plan of operations and ensures fiscal integrity, regulatory compliance, and long-term financial sustainability through comprehensive management of accounting, budgeting, revenue cycle, reimbursement, investments, and strategic financial planning, annual audit(s), and long-range financial planning.
The CFO partners across departments to strengthen financial performance, optimize reimbursement and payer relationships, and identify opportunities for growth, expansion, and innovation. Through strategic leadership, transparency, and collaboration, the CFO safeguards financial sustainability and reinforces the Agency's capacity to deliver exceptional care to patients, families, and the community.
Positions Supervised: Finance Director: manages payroll, A/P, A/R, 1099s, and medical billing. Café Chef: manages the day-to-day operations and direct oversight of the café.
Minimum Qualifications
Bachelor's degree in accounting, finance, or Business Administration required; Master's or MBA preferred.
CPA, CMA, or CHFP credential preferred.
At least 7 years of progressive finance experience with 3+ years in leadership roles.
Healthcare or nonprofit sectors preferred.
Expertise in budgeting, forecasting, reimbursement, and data analytics.
Knowledge of hospice and palliative care reimbursement models, including managed care and value-based contracts.
Advanced proficiency in Excel, financial software, and dashboard tools (Power BI or equivalent).
Strong interpersonal, analytical, and communication skills.
Must be committed to the Hospice concept and standards.
Must be available for on-call duty.
Possess knowledge of licensing requirements for Hospice in the state of North Carolina.
Leadership Standards:
Exemplifies Leadership and Core Values Demonstrates and models the Agency's core values in all decisions and interactions. Holds self and others accountable for upholding adopted values, standards of excellence, and ethical conduct.
Drives Team and Agency Success Communicates with purpose and consistency, producing high-quality work that reflects a strong personal investment in the success of the agency, team, and individual staff members.
Recognizes and Develops Others Actively recognizes the achievements of colleagues and staff. educates and mentors colleagues on financial policies, processes, and best practices, fostering agency understanding, accountability, and consistency in fiscal operations.
Fosters a Collaborative and Supportive Culture Creates and maintains a professional, inclusive, and authentic work environment where collaboration, trust, and respect are encouraged and sustained.
Leads Through Innovation and Problem Solving Proactively identifies challenges, contributes to resolution, and presents thoughtful, data-informed recommendations that enhance communication, processes, and agency performance.
Engages in Agency and Community Leadership Actively represents the agency by attending and contributing to internal events, cross-departmental meetings, and community forums. Builds relationships that strengthen the agency's visibility, partnerships, and mission impact.
Job Duties & Responsibilities
Financial Leadership and Strategic Planning
Serve as the Chief Financial Officer under Agency bylaws, ensuring compliance with GAAP, CMS, IRS, and state regulations.
Lead the development, implementation, and evaluation of the Agency's financial plan of operations, aligning fiscal performance with patient volume (ADC), staffing needs, and service utilization.
Prepare and present comprehensive annual and multi-year operating and capital budgets that reflect anticipated volumes, revenues, expenses, and workforce requirements.
Monitor the economic environment and advise executive leadership and the Board on potential impacts, risks, and opportunities to ensure proactive financial planning and organizational stability.
Conduct ongoing cost and utilization analyses to optimize efficiency and profitability across service lines.
Develop a financial growth plan to support the expansion of services, acquisitions, and strategic partnerships.
Forecast and analyze trends in reimbursement, labor costs, and payer mix to inform financial strategy.
Provide strategic management of investments and cash reserves to ensure optimal return on investment (ROI) consistent with risk tolerance and Board policy.
Oversee all aspects of financial modeling, forecasting, and long-term planning for the Agency.
Provide scenario-based analysis to assess the impact of strategic decisions, including growth, acquisitions, and new service lines.
Support data-driven decision-making through proactive financial modeling and performance reporting.
Accounting, Compliance, and Audit
Direct all accounting operations, including general ledger, accounts payable, accounts receivable, payroll reconciliation, and month-end close.
Ensure accurate financial reporting and compliance with GAAP, Medicare cost reporting, and nonprofit accounting standards.
Oversee annual audit, tax filings (Form 990), and coordination with external auditors and CPA firm(s).
Develop, implement, and oversee financial policies, internal controls, and investment policies that ensure fiscal transparency and asset protection.
Maintain restricted fund accounting for grants, donations, and endowments in accordance with donor intent and FASB ASC 958 standards.
Oversee proper classification and tracking of temporarily restricted and unrestricted contributions and reconcile monthly between the donor database and the general ledger.
Ensure accurate recording, reporting, and release of restricted funds and in-kind donations.
Ensure compliance with the Agency's Gift Acceptance Policy and provide financial support for donor stewardship and grant reporting.
Monitor potential compliance risks within revenue, accounting, or contracting functions.
Coordinate fiscal components of the Agency's risk management and insurance programs.
Partner with the Compliance Officer to maintain audit readiness and financial documentation integrity.
Serve as Agency liaison to the Board Sub Committees and QAPI, providing transparent fiscal governance and financial reporting.
Revenue Cycle and Reimbursement Management
Oversee all functions of the revenue cycle, including billing, collections, accounts receivable management, payment posting, and denial resolution.
Ensure compliance with payer regulations for Medicare, Medicaid, Managed Care, and other insurers.
Monitor Days in AR, clean claim rate, denial rate, and cash collections to ensure optimal cash flow.
Collaborate across teams to improve claim accuracy and timeliness.
Analyze reimbursement trends and support the negotiation of payer contracts, cap management, and value-based initiatives.
Develop revenue dashboards that integrate operational and clinical data to improve forecasting accuracy.
Budget Development and Management
Manage the annual budget process, establishing timelines, templates, and collaboration protocols.
Coordinate department-level budget meetings and ensure consistency across divisions.
Analyze monthly budget-to-actual variances and report to the CAO, CEO, and Board.
Maintain control of capital expenditures, ensuring alignment with budgeted priorities.
Provide education and support to department leaders to enhance budget literacy and accountability.
Board Governance and Reporting
Serve as the financial liaison to the Board of Directors, presenting financial reports, key metrics, and strategic recommendations.
Support Board Committees by preparing and presenting detailed financial information and compliance updates.
Collaborate with the CAO and CEO to ensure transparent governance and informed fiscal oversight.
Applies performance and compliance data to guide policy development and Agency decisions.
Performance Indicators
Timeliness and accuracy of financial reports and dashboards.
Positive audit results and compliance with policies.
Growth in diversified payer contracts and value-based initiatives.
Improved Revenue Cycle Management (RCM) efficiency and reduced denials.
Implementation of financial dashboards and data tools.
Successful launch and tracking innovative service lines.
Attends required in-services on an annual basis:
Risk Management
Bloodborne Pathogens/TB
Body Mechanics
Fire Safety
General Safety/Hazardous Materials
Patient/Staff Relations
Disaster Plan/Drill
Maintains a safe and clean work area to promote workplace safety.
Maintains confidentiality of Protected Health Information (PHI) at all times.
Document services and expenditures for reimbursement purposes.
Performs other duties or special projects as requested by the CAO or CEO.
Participates in the QAPI program.
Participates in Hospice committees as needed.
Performs job duties in accordance with all Hospice policies, procedures, and professional standards
Abides by the Hospice Professional Code of Conduct.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, sit, use hand to finger, handle or feel objects, tools or controls; and reach with hands and arms to talk or to hear.
The employee is occasionally required to stand, walk, climb, or balance; stoop, kneel, crouch, or craw and detect odors. The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities required by this job include close, distance, color, peripheral and depth perception and the ability to adjust focus.
Status and Hours of Work
Full-time, Exempt. Eligible for full Agency benefits package. Usual working hours are 8 a.m. to 5 p.m., Monday through Friday, or as needed to perform duties. This position is not eligible for overtime pay.
Chief Financial Officer (CFO)
Primary Function
The Chief Financial Officer (CFO) provides leadership and oversight of all financial management functions at Hospice of Davidson County (Agency). This position reports to the Chief Administrative Officer (CAO) and is indirectly supervised by the Chief Executive Officer (CEO). The CFO has a dotted-line reporting relationship to the CEO.
The CFO develops and implements the Agency's financial plan of operations and ensures fiscal integrity, regulatory compliance, and long-term financial sustainability through comprehensive management of accounting, budgeting, revenue cycle, reimbursement, investments, and strategic financial planning, annual audit(s), and long-range financial planning.
The CFO partners across departments to strengthen financial performance, optimize reimbursement and payer relationships, and identify opportunities for growth, expansion, and innovation. Through strategic leadership, transparency, and collaboration, the CFO safeguards financial sustainability and reinforces the Agency's capacity to deliver exceptional care to patients, families, and the community.
Positions Supervised: Finance Director: manages payroll, A/P, A/R, 1099s, and medical billing. Café Chef: manages the day-to-day operations and direct oversight of the café.
Minimum Qualifications
Bachelor's degree in accounting, finance, or Business Administration required; Master's or MBA preferred.
CPA, CMA, or CHFP credential preferred.
At least 7 years of progressive finance experience with 3+ years in leadership roles.
Healthcare or nonprofit sectors preferred.
Expertise in budgeting, forecasting, reimbursement, and data analytics.
Knowledge of hospice and palliative care reimbursement models, including managed care and value-based contracts.
Advanced proficiency in Excel, financial software, and dashboard tools (Power BI or equivalent).
Strong interpersonal, analytical, and communication skills.
Must be committed to the Hospice concept and standards.
Must be available for on-call duty.
Possess knowledge of licensing requirements for Hospice in the state of North Carolina.
Leadership Standards:
Exemplifies Leadership and Core Values Demonstrates and models the Agency's core values in all decisions and interactions. Holds self and others accountable for upholding adopted values, standards of excellence, and ethical conduct.
Drives Team and Agency Success Communicates with purpose and consistency, producing high-quality work that reflects a strong personal investment in the success of the agency, team, and individual staff members.
Recognizes and Develops Others Actively recognizes the achievements of colleagues and staff. educates and mentors colleagues on financial policies, processes, and best practices, fostering agency understanding, accountability, and consistency in fiscal operations.
Fosters a Collaborative and Supportive Culture Creates and maintains a professional, inclusive, and authentic work environment where collaboration, trust, and respect are encouraged and sustained.
Leads Through Innovation and Problem Solving Proactively identifies challenges, contributes to resolution, and presents thoughtful, data-informed recommendations that enhance communication, processes, and agency performance.
Engages in Agency and Community Leadership Actively represents the agency by attending and contributing to internal events, cross-departmental meetings, and community forums. Builds relationships that strengthen the agency's visibility, partnerships, and mission impact.
Job Duties & Responsibilities
Financial Leadership and Strategic Planning
Serve as the Chief Financial Officer under Agency bylaws, ensuring compliance with GAAP, CMS, IRS, and state regulations.
Lead the development, implementation, and evaluation of the Agency's financial plan of operations, aligning fiscal performance with patient volume (ADC), staffing needs, and service utilization.
Prepare and present comprehensive annual and multi-year operating and capital budgets that reflect anticipated volumes, revenues, expenses, and workforce requirements.
Monitor the economic environment and advise executive leadership and the Board on potential impacts, risks, and opportunities to ensure proactive financial planning and organizational stability.
Conduct ongoing cost and utilization analyses to optimize efficiency and profitability across service lines.
Develop a financial growth plan to support the expansion of services, acquisitions, and strategic partnerships.
Forecast and analyze trends in reimbursement, labor costs, and payer mix to inform financial strategy.
Provide strategic management of investments and cash reserves to ensure optimal return on investment (ROI) consistent with risk tolerance and Board policy.
Oversee all aspects of financial modeling, forecasting, and long-term planning for the Agency.
Provide scenario-based analysis to assess the impact of strategic decisions, including growth, acquisitions, and new service lines.
Support data-driven decision-making through proactive financial modeling and performance reporting.
Accounting, Compliance, and Audit
Direct all accounting operations, including general ledger, accounts payable, accounts receivable, payroll reconciliation, and month-end close.
Ensure accurate financial reporting and compliance with GAAP, Medicare cost reporting, and nonprofit accounting standards.
Oversee annual audit, tax filings (Form 990), and coordination with external auditors and CPA firm(s).
Develop, implement, and oversee financial policies, internal controls, and investment policies that ensure fiscal transparency and asset protection.
Maintain restricted fund accounting for grants, donations, and endowments in accordance with donor intent and FASB ASC 958 standards.
Oversee proper classification and tracking of temporarily restricted and unrestricted contributions and reconcile monthly between the donor database and the general ledger.
Ensure accurate recording, reporting, and release of restricted funds and in-kind donations.
Ensure compliance with the Agency's Gift Acceptance Policy and provide financial support for donor stewardship and grant reporting.
Monitor potential compliance risks within revenue, accounting, or contracting functions.
Coordinate fiscal components of the Agency's risk management and insurance programs.
Partner with the Compliance Officer to maintain audit readiness and financial documentation integrity.
Serve as Agency liaison to the Board Sub Committees and QAPI, providing transparent fiscal governance and financial reporting.
Revenue Cycle and Reimbursement Management
Oversee all functions of the revenue cycle, including billing, collections, accounts receivable management, payment posting, and denial resolution.
Ensure compliance with payer regulations for Medicare, Medicaid, Managed Care, and other insurers.
Monitor Days in AR, clean claim rate, denial rate, and cash collections to ensure optimal cash flow.
Collaborate across teams to improve claim accuracy and timeliness.
Analyze reimbursement trends and support the negotiation of payer contracts, cap management, and value-based initiatives.
Develop revenue dashboards that integrate operational and clinical data to improve forecasting accuracy.
Budget Development and Management
Manage the annual budget process, establishing timelines, templates, and collaboration protocols.
Coordinate department-level budget meetings and ensure consistency across divisions.
Analyze monthly budget-to-actual variances and report to the CAO, CEO, and Board.
Maintain control of capital expenditures, ensuring alignment with budgeted priorities.
Provide education and support to department leaders to enhance budget literacy and accountability.
Board Governance and Reporting
Serve as the financial liaison to the Board of Directors, presenting financial reports, key metrics, and strategic recommendations.
Support Board Committees by preparing and presenting detailed financial information and compliance updates.
Collaborate with the CAO and CEO to ensure transparent governance and informed fiscal oversight.
Applies performance and compliance data to guide policy development and Agency decisions.
Performance Indicators
Timeliness and accuracy of financial reports and dashboards.
Positive audit results and compliance with policies.
Growth in diversified payer contracts and value-based initiatives.
Improved Revenue Cycle Management (RCM) efficiency and reduced denials.
Implementation of financial dashboards and data tools.
Successful launch and tracking innovative service lines.
Attends required in-services on an annual basis:
Risk Management
Bloodborne Pathogens/TB
Body Mechanics
Fire Safety
General Safety/Hazardous Materials
Patient/Staff Relations
Disaster Plan/Drill
Maintains a safe and clean work area to promote workplace safety.
Maintains confidentiality of Protected Health Information (PHI) at all times.
Document services and expenditures for reimbursement purposes.
Performs other duties or special projects as requested by the CAO or CEO.
Participates in the QAPI program.
Participates in Hospice committees as needed.
Performs job duties in accordance with all Hospice policies, procedures, and professional standards
Abides by the Hospice Professional Code of Conduct.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation(s) may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, sit, use hand to finger, handle or feel objects, tools or controls; and reach with hands and arms to talk or to hear.
The employee is occasionally required to stand, walk, climb, or balance; stoop, kneel, crouch, or craw and detect odors. The employee must occasionally lift and/or move up to 30 pounds. Specific vision abilities required by this job include close, distance, color, peripheral and depth perception and the ability to adjust focus.
Status and Hours of Work
Full-time, Exempt. Eligible for full Agency benefits package. Usual working hours are 8 a.m. to 5 p.m., Monday through Friday, or as needed to perform duties. This position is not eligible for overtime pay.