The Chief Financial & Operations Officer (CFOO) serves as a key member of the executive leadership team and is responsible for aligning RiverPeak Health’s financial strategy with operational execution.
This role is uniquely positioned to help build the organization from the ground up, establishing financial systems, operational infrastructure, and leadership frameworks necessary to successfully launch and sustain a high-performing rural health system.
The CFOO provides executive oversight of finance, revenue cycle, and assigned operational departments, ensuring strong financial stewardship, operational efficiency, regulatory compliance, and high-quality patient care delivery.
Reporting Structure
Reports To: Chief Executive Officer (CEO)
Position Context
RiverPeak Health is a newly developing healthcare organization with no existing operational staff at the time of hire. The CFOO will play a foundational role in:
Building financial and operational infrastructure from inception
Supporting recruitment and onboarding of leadership and staff
Partnering in facility activation, service line development, and go-live readiness
Establishing a culture aligned with RiverPeak’s mission, values, and rural community focus
Key Responsibilities
Executive Leadership & Strategy
Serve as a strategic partner to the CEO, Board, and leadership team
Participate in organizational strategic planning, business development, and growth initiatives
Translate strategic priorities into financial and operational plans
Support Board committees and provide regular financial and operational reporting
Financial Leadership
Lead all financial functions, including:
Budgeting and forecasting
Financial reporting and analysis
Capital planning
Cash flow and treasury management
Develop and execute financial strategies aligned with a Prospective Payment System (PPS) reimbursement environment, including optimization of case mix index, service line performance, and payer mix
Establish financial systems, policies, and internal controls
Ensure compliance with GAAP, regulatory requirements, and grant/funding obligations
Oversee cost reporting, audits, and reimbursement optimization
Revenue Cycle & Financial Performance
Lead financial modeling and decision-making in a fixed-reimbursement environment, ensuring sustainable margins and long-term financial viability
Oversee revenue cycle operations, including billing, coding, collections, and payer relationships
Monitor key financial and operational performance indicators
Drive initiatives to improve margin, productivity, and cost efficiency
Support payer contracting and reimbursement strategy
Operational Oversight
Provide executive oversight of assigned operational departments
Ensure alignment between clinical operations and financial performance
Lead operational readiness efforts for facility opening (staffing, workflows, systems)
Partner with clinical and administrative leaders to optimize service delivery
Prior experience in start-up, growth, or organizational build environments highly desirable
Knowledge, Skills, & Abilities
Strong financial acumen and analytical capability
Ability to translate data into actionable insights
Demonstrated leadership and team-building skills
Strong communication skills with ability to engage Board, physicians, and staff
Knowledge of healthcare reimbursement, regulatory requirements, and financial systems
Ability to manage multiple priorities in a fast-paced, evolving environment
Working Conditions
Primarily office-based with frequent interaction across departments
Participation in leadership meetings, Board meetings, and community engagement
Ability to manage competing priorities in a dynamic start-up environment
Disclaimer
This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications. Responsibilities may be adjusted as organizational needs evolve.
RiverPeak Health is a newly developed, full-service community hospital in Riverton, Wyoming, designed to expand access to high-quality care in a rural region. Scheduled to open in late 2026, RiverPeak Health will operate as a Prospective Payment System (PPS) hospital and offer a comprehensive range of services including emergency care, inpatient medical and surgical services, labor and delivery, diagnostic imaging, laboratory, and pharmacy services.
At opening, the hospital will include a 13-bed inpatient unit (11 medical/surgical beds and 2 labor and delivery beds) and is being developed in close collaboration with Billings Clinic to ensure strong clinical integration, operational support, and long-term sustainability.
RiverPeak Health is building its team from the ground up, offering a unique opportunity for leaders and staff to shape the culture, care delivery model, and patient experience from day one. The organization is committed to fostering a collaborative, mission-driven environment focused on patient-centered care, employee engagement, and community impact.