We are a rapidly growing, multi-state behavioral health practice (~40 providers across 10 states), providing psychiatry, therapy, TMS, and collaborative care services. We've nearly doubled revenue over the past year and expect to double provider headcount again in the next 18 months. With strong momentum in TMS and collaborative care, and opportunities ahead in specialty clinics and Spravato, we need senior finance leadership to help us sustain growth with discipline.
Location:
Remote (U.S. time zone alignment preferred)
Commitment:
~8–12 hrs/wk during initial ramp (first 2–3 months), then ~5 hrs/wk steady state
Compensation:
$150-250/hour depending on fit and experience.
Role Overview
The Fractional CFO will partner with the CEO and leadership team to provide
strategic financial leadership
, ensure
accurate and decision-ready financials
, and build the forecasting and capital models we need to grow responsibly. During the initial ramp period, the CFO will spend more time hands-on building the forecasting models, cash planning tools, and financial oversight processes. After these foundations are in place, the role will shift to a lighter, ongoing commitment focused on forecasting, capital readiness, and light oversight of controls.
Key Responsibilities
Strategic Finance & FP&A
* Build and maintain a
driver-based forecast
tied to provider ramp, payer mix, reimbursement rates, service type, billing, and service utilization..
* Develop and manage a
13-week cash flow model
and payroll risk calendar.
* Prepare and present
monthly leadership financial packages
, including P&L, balance sheet, cash flow, service-line P&L, and variance analysis.
* Partner with operations to evaluate
new initiatives
(e.g., new clinics, TMS machines, Spravato, collaborative care) through structured ROI, impact, and pilot testing frameworks.
* Identify and pursue
capital opportunities
(e.g., line of credit, equipment financing, grants), including preparing lender/partner-ready decks.
Light Oversight of Close & Controls
* Oversee the
month-end close
(10 business days target), including accruals, reconciliations, and COA hygiene, in partnership with the bookkeeper.
* Work with billing management to refine policies around
refunds, write-offs, and vendor setup governance
.
* Ensure segregation of duties and compliance controls remain in place and functional.
* Coordinate with the external accountant for quarterly reviews and tax planning.
Leadership & Collaboration
* Serve as a thought partner to the CEO and leadership team, constructively challenging assumptions and facilitating
data-driven decisions
.
* Communicate complex financial information clearly to both financial and non-financial leaders.
Build and mentor internal finance processes so that over time, fewer decisions rely solely on CFO's bandwidth.
Success in 90 Days
* A live
13-week cash flow model
with weekly updates.
* A
driver-based forecast
that leadership can trust for the next 3–6 months.
* A
stage-gate process
for evaluating new initiatives.
* Monthly
financial packages
that the CEO and leadership can rely on without re-checking numbers.
Qualifications
* 7–10+ years of senior financial leadership in healthcare (behavioral health, multi-state, or high-growth ambulatory preferred).
* Demonstrated success in building FP&A models and leading capital raises/LOC negotiations.
* Solid understanding of
revenue cycle management
, healthcare reimbursement, and multi-state compliance requirements.
* Experience with
QuickBooks Online, AdvancedMD (or similar EHR/billing platforms), and BI tools
(Google Data Studio, Power BI).
* Strong grasp of
financial controls, accrual accounting, and reconciliations
(controller-level knowledge).
* Excellent communication skills; proven ability to partner with clinical and operational leaders.
Preferred:
CPA or MBA; prior experience with outpatient behavioral health services (including medication management and psychotherapy), TMS, collaborative care, or other behavioral health service-line P&Ls.
How to apply
1. Interested candidates should submit a resume and a brief statement outlining:
Their experience with
driver-based forecasting
and
13-week cash modeling
.
2. Examples of capital planning (LOC, equipment financing, grants) they've led.
3. A 90-day approach for quickly stabilizing and adding value in a high-growth behavioral health setting.