Chief Financial Officer (CFO)

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.

Responsibilities:

• Executive Leadership & Mission Stewardship
• Serve as a strategic partner to the CEO and a trusted financial advisor to the Board of Directors.
• Integrate financial strategy with the hospital’s nonprofit mission, community benefit obligations, and charitable purpose.
• Support Board governance by providing timely, accurate, and transparent financial reporting and analysis.
• Participate actively in organizational strategy, service line planning, and long-range financial sustainability discussions.
• Ensure financial decisions align with ethical standards, nonprofit fiduciary duties, and public trust expectations.
• Start-Up, Pre-Opening & Organizational Development
• Lead all financial planning and execution for hospital start-up activities, including:
• Multi-year pro forma development
• 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.
• Financial Planning, Budgeting & Performance Management
• 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.
• Revenue Cycle Management & Reimbursement Strategy
• Oversee all aspects of the revenue cycle, including:
• Patient financial services
• 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.
• Accounting, Audit, and Financial Reporting
• 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.
• Treasury, Capital Structure & Financial Sustainability
• 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.
• Compliance, Risk Management & Regulatory Oversight
• 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.
• Board, Committee & External Relations
• Serve as the primary financial liaison to the Board Finance Committee and Audit Committee.
• Prepare and present financial reports, dashboards, and strategic analyses for Board review.
• Support Board education on financial performance, risks, and industry trends in behavioral health.
• Represent the organization with external stakeholders, including auditors, regulators, donors, and community partners.
• Finance Team Leadership & Culture Building
• Recruit, develop, and lead a high-performing finance, accounting, and revenue cycle team.
• Establish a culture of fiscal accountability, ethical stewardship, and continuous improvement.
• Implement scalable systems and processes to support organizational growth.
• Promote cross-functional collaboration between finance, clinical, and operational teams.

Requirements/Qualifications

Qualifications:

Education

• Bachelor’s degree in Finance, Accounting, Business Administration, or related field (required).
• MBA, MHA, CPA, or equivalent advanced credential (strongly preferred).

Experience

• Minimum of 12–15 years of progressive financial leadership experience in healthcare.
• Demonstrated experience in:
• Nonprofit hospital or healthcare system finance
• Behavioral health or psychiatric hospital operations (strongly preferred)
• De novo hospital development or major organizational start-up
• Experience working directly with Boards of Directors and Board committees.
• Proven success managing revenue cycle operations and payer contracting in complex reimbursement environments.

Knowledge, Skills & Attributes

• Expert knowledge of nonprofit healthcare finance, including fund accounting and community benefit reporting.
• Deep understanding of psychiatric hospital reimbursement, parity laws, and regulatory requirements.
• Strong financial modeling, forecasting, and analytical skills.
• Ability to operate effectively in a start-up environment with evolving infrastructure.
• Exceptional communication skills, with the ability to present complex financial concepts clearly to diverse stakeholders.
• Demonstrated integrity, sound judgment, and commitment to the nonprofit mission.

Hospital/Program Description

Living in Midland, Texas adds to the appeal, offering a high quality of life with affordable housing, short commutes, excellent schools, and a welcoming community. Midland blends small-city convenience with big-opportunity energy, featuring a vibrant arts scene, outdoor recreation, and easy access to regional travel—making it an ideal place to grow both professionally and personally.

Working at Permian Basin Behavioral Health Center offers the rare opportunity to be part of a brand-new, mission-driven organization that is transforming access to behavioral health care across West Texas and Southeastern New Mexico. Team members play a meaningful role in building programs, shaping culture, and directly impacting lives in a growing region with a strong sense of purpose and collaboration.

Transforming Lives. Restoring Hope.

Permian Basin Behavioral Health Center (PBBHC) is a new, comprehensive mental health center serving the Permian Basin region of West Texas and Southeastern New Mexico. Conveniently located between Midland and Odessa, PBBHC will offer both inpatient and outpatient behavioral health services for individuals of all ages.