The Fractional CFO provides part-time executive financial leadership for a municipal non-profit ambulance organization. This role is responsible for ensuring financial sustainability, regulatory compliance, and strategic alignment with the organization's mission to deliver high-quality emergency medical services (EMS) to the community. The Fractional CFO works closely with executive leadership, municipal stakeholders, and the governing board to manage public funds responsibly, optimize reimbursement revenue, and support long-term operational viability.

Key Responsibilities

Financial StrategyMunicipal Alignment

Developimplement financial strategies aligned with the organization's mission and municipal expectations
Advise leadership on financial implications of service expansion, staffing models, and capital investments (e.g. ambulances, equipment)
Support long-term financial planning, including sustainability of EMS operations in a public/non-profit context

Budgeting, ForecastingFund Accounting

Lead development of annual operating and capital budgets
Monitor budget-to-actual performance and provide variance analysis
Oversee fund accounting practices, including restricted and unrestricted funds
Assist in financial reporting required by municipal partners and governing bodies

Revenue CycleReimbursement Optimization

Oversee EMS billing and collections processes, including Medicare, Medicaid, and private insurance reimbursements
Analyze payer mix and reimbursement trends to identify revenue improvement opportunities
Ensure compliance with healthcare billing regulations and documentation requirements
Collaborate with billing vendors or internal staff to improve revenue cycle efficiency

Cash FlowFinancial Sustainability

Monitor cash flow, liquidity, and reserve levels
Develop strategies to manage fluctuations in reimbursement timing and funding cycles
Provide recommendations for maintaining adequate operating reserves

Grants, FundingCompliance

Support identification, application, and management of grants (local, state, and federal)
Ensure proper tracking and reporting of grant funds in accordance with requirements
Assist with compliance related to municipal funding, contracts and intergovernmental agreements

Accounting OversightAudit Coordination

Oversee accounting functions to ensure accuracy and compliance with GAAP for non-profits
Prepare and review financial statements and board reports
Coordinate annual audits and serve as liaison with external auditors
Ensure timely filing of required reports (e.g. IRS Form 990, state filings)

Risk ManagementInternal Controls

Establish and maintain internal financial controls to safeguard public funds
Identify financial risks related to operations, reimbursement, or funding sources
Ensure compliance with applicable regulations, including healthcare and municipal requirements

SystemOperational Efficiency

Evaluate financial systems, billing platforms, and reporting tools
Recommend and implement improvements to enhance efficiency and transparency
Support data-driven decision-making through KPI development (e.g. cost per transport, collection rates, unit hour utilization)

Stakeholder Communication

Present financial reports and strategic insights to executive leadership, board members, and municipal officials.
Translate complex financial data into clear, actionable information for non-financial stakeholders
Support transparency and accountability in public-facing financial reporting

Qualifications

Bachelor's degree in Finance, Accounting, or related field (CPA strongly preferred)
10+ years of financial leadership experience, preferably in non-profit, healthcare, EMS or municipal environments
Strong knowledge of non-profit accounting standards and fund acounting
Experience with healthcare reimbursement systems (Medicare/Medicaid) highly preferred
Familiarity with grant management and public funding structures
Proven experience working with boards, government entities, or public agencies

Key SkillsCompetencies

Strategic financial leadership in mission-driven organizations
Deep understanding of EMS or healthcare financial dynamics
Strong analytical and forecasting capabilities
Excellent communications skills for diverse stakeholders
High level of integrity and commitment to public stewardship
Ability to navigate regulatory and compliance requirements

Work Structure

Part-time/contract/retainer-based role
Flexible schedule based on organizational needs and reporting cycles
May be remote with periodic on-site or board meeting attendance
Expected to engage regularly with leadership and key stakeholders

Typical Deliverables

Monthly financial statements and board reports
Annual operating and capital budgets
Cash flow projections and sustainability plans
Grant financial reports and compliance documentation
Revenue cycle performance analysis
Other tasks as assigned by the Director

MEDIC1

New Jobs

Fractional Chief Financial Officer (CFO)