Chief Financial Officer

Job Description

Job Description

Chief Financial Officer (CFO- Must have Skilled Nursing Experience)
Location: Charleston, Illinois (On-Site)
Travel: Required (Multi-State Portfolio)
*Relocation Assistance Available for Qualified Candidates Relocating to Charleston, IL or Surrounding Areas

About the Opportunity

A growing, multi-state skilled nursing organization is seeking a highly experienced and hands-on Chief Financial Officer (CFO) to lead and scale the financial and revenue cycle operations of the company. This is a critical executive role for a leader who not only understands the complexities of skilled nursing finance, but also has a proven ability to drive performance, accountability, and results across both finance and billing functions.

This position requires direct Skilled Nursing Facility (SNF) experience. Applicants without SNF, long-term care, or nursing home finance and reimbursement experience will not be considered.

The CFO will play a key role in supporting continued growth, ensuring strong cash flow, and building a best-in-class back-office infrastructure.

Key Responsibilities

Strategic Financial Leadership

• Serve as a key advisor to ownership and executive leadership on financial strategy, growth initiatives, and risk management

• Lead financial planning, forecasting, and modeling for acquisitions, expansions, and operational improvements

• Drive data-informed decision-making across all levels of the organization

Financial Operations & Oversight

• Oversee all accounting, budgeting, financial reporting, and cash flow management across a multi-state portfolio

• Ensure timely and accurate preparation of financial statements and reporting packages

• Establish and maintain strong internal controls and scalable financial systems

Revenue Cycle & Billing Oversight (CORE FOCUS)

• Directly oversee the entire billing and collections process across all facilities

• Lead and manage back-office operations, including billers and revenue cycle teams

• Ensure timely and accurate billing, with strict adherence to deadlines and regulatory requirements

• Drive collections performance with a target of 95%+ collection rates

• Identify, investigate, and resolve billing discrepancies and revenue leakage

• Implement processes to reduce denials, improve cash flow, and increase operational efficiency

• Hold billing teams accountable to performance metrics, timelines, and quality standards

Skilled Nursing & Reimbursement Expertise

• Oversee and optimize Medicare and Medicaid reimbursement processes

• Analyze payer mix, PDPM performance, and reimbursement trends to maximize revenue

• Partner with clinical and operations teams to align financial outcomes with quality care

Regulatory & Compliance

• Ensure full compliance with all federal and state financial regulations

• Lead and support Change of Ownership (CHOW) processes, including financial structuring and reporting

• Oversee cost reporting, audits, and all regulatory financial submissions

Growth & Transactions

• Lead financial due diligence for acquisitions and support integration efforts post-close

• Partner with legal, compliance, and operations teams during transitions and expansions

• Build financial infrastructure to support a rapidly growing organization

Team Leadership

• Build, lead, and mentor both finance and billing teams

• Establish clear KPIs, accountability structures, and performance expectations

• Create a culture of ownership, urgency, and continuous improvement

Operational Excellence

• Identify opportunities to improve margins, reduce costs, and increase efficiency

• Monitor key financial and operational KPIs across facilities

• Implement best practices and scalable processes across all entities

Qualifications

• Bachelor’s degree in Accounting, Finance, or related field (CPA or MBA strongly preferred)

• MUST have direct Skilled Nursing Facility (SNF) experience

• Applicants must have experience specifically within skilled nursing, long-term care, or nursing home operations/finance

• 7–10+ years of progressive financial leadership experience, including oversight of multi-site operations

• Proven experience managing billing, collections, and revenue cycle operations in SNF settings

Deep Understanding of:

• Medicare and Medicaid reimbursement

• SNF billing processes and compliance requirements

• CHOW (Change of Ownership) processes

• Cost reporting and financial audits

• Demonstrated success improving collections, cash flow, and billing accuracy

• Experience leading and managing back-office billing teams

• Strong leadership, communication, and organizational skills

• Hands-on, roll-up-your-sleeves approach with the ability to operate both strategically and tactically

Additional Requirements

• Willingness and ability to travel across multiple states as needed

• Must be based in or willing to relocate to Charleston, Illinois or nearby surrounding communities

• Relocation assistance/package available for qualified candidates

• High level of integrity, accountability, and attention to detail

• Ability to thrive in a fast-paced, high-growth environment