Chief Financial Officer; CFO

Chief Financial Officer, Permian Basin Behavioral Health Center, Midland TX

Reports To:Chief Executive Officer (CEO)

The Chief Financial Officer (CFO) serves as the principal financial executive of a newly established, nonprofit psychiatric hospital, the Permian Basin Behavioral Health Center. The CFO is a key architect of the organization’s financial sustainability, transparency, and mission stewardship. As a founding executive leader, the CFO is responsible for designing, implementing, and overseeing all financial functions from pre-opening through operational stabilization and long-term growth.

The CFO balances financial discipline with mission-driven priorities, ensuring the hospital remains fiscally sound while expanding access to high-quality behavioral health services for the community, including underserved and vulnerable populations. The role requires deep expertise in behavioral health finance, nonprofit hospital operations, reimbursement strategy, and regulatory compliance, as well as strong partnership with executive leadership, physicians, and the Board.

• Lead all financial planning and execution for hospital start-up activities.
• Start-up capital budgeting and cost controls.
• Ramp-up cash flow modeling through census stabilization.
• Establish the hospital’s financial infrastructure from inception, including:
• Accounting systems and chart of accounts.
• Financial policies and procedures.
• Internal controls and segregation of duties.
• Collaborate with executive and clinical leadership on licensure, accreditation, and readiness activities, ensuring financial compliance and documentation are survey-ready.
• Support grant funding, philanthropic contributions, and donor-restricted fund tracking during start-up, as applicable.

• Develop and oversee the annual operating and capital budgets in collaboration with department leaders and clinical leadership.
• Implement multi-year financial planning and rolling forecasts tied to census, acuity, and payer mix assumptions.
• Monitor organizational financial performance against budget, benchmarks, and strategic goals.
• Establish and report on key financial and operational KPIs, translating financial data into actionable insights.
• Proactively identify financial risks and opportunities and recommend mitigation or optimization strategies.

• Oversee all aspects of the revenue cycle, including:
• Coding, billing, and claims management.
• Denials prevention and appeals.
• Accounts receivable and cash collections.
• Lead payer contracting strategy across Medicaid, Medicare (if applicable), managed Medicaid, and commercial payers, with specific expertise in behavioral health reimbursement structures.
• Optimize payer mix and reimbursement methodologies while maintaining access for mission-critical populations.
• Ensure compliance with federal and state billing regulations, including nonprofit-specific reimbursement requirements.
• Monitor evolving behavioral health payment models, parity regulations, and value-based care opportunities.

• Oversee all accounting functions, including general ledger, payroll, accounts payable/receivable, and fixed assets.
• Ensure timely and accurate monthly, quarterly, and annual financial statements in accordance with GAAP and nonprofit accounting standards.
• Lead preparation for annual independent financial audits and oversee corrective action plans, as necessary.
• Ensure accurate reporting of restricted and unrestricted funds, grants, and community benefit expenditures.
• Support transparency and accountability to regulators, funders, donors, and the public.

• Manage cash flow, liquidity, and reserves to ensure operational continuity during start-up and growth phases.
• Oversee relationships with banks, bondholders, philanthropic partners, and other financial stakeholders.
• Support tax-exempt financing, bond compliance, and debt covenant monitoring, if applicable.
• Lead capital planning for facility development, equipment acquisition, IT systems, and future expansion.
• Develop long-term strategies for financial resilience, including reserve policies and risk mitigation plans.

• Ensure compliance with all federal, state, and local financial regulations applicable to nonprofit healthcare organizations.
• Partner with compliance, legal, and clinical leadership to mitigate financial and reimbursement risk.
• Oversee policies related to fraud and abuse prevention, cost reporting, and financial disclosures.
• Support regulatory reporting requirements, including cost reports, grant reporting, and nonprofit disclosures.

• Serve as the primary financial liaison to the Board Finance Committee and Audit Committee.
• Prepare and present financial reports, dashboards, and…