The shifting healthcare CFO role: Career challenges in centralized systems


Guest post by Tom Quinn, a senior partner with the executive search firm Witt/Kieffer.

Editor's note: This is part two of a two-part series. Here's part one.

Healthcare systems in the U.S. are centralizing their financial operations as industry consolidation continues. Understandably, this disruption is prompting some unease among chief financial officers and a very good question:

How can enterprising CFOs at all levels--site, divisional and system--grow along with their organizations?

Several healthcare CFOs recently shared with me their answers to that question. Among their key thoughts:

  • New corporate financial liaison roles are becoming typical, especially in large systems.
  • It's imperative for site and divisional CFOs to understand system strategy.
  • "Soft" skills of collaboration, communication, negotiation and advocacy can be as important as "hard" skills of accounting, financial reporting and data analysis.

Carl Francioli, CFO of Johns Hopkins Bayview Medical Center in Baltimore, embraces his liaison role. "I am a strategic partner for the local leadership team with a strong tie into the corporate services for other functions like cost and general ledger accounting, and patient financial services," he explains. "The entity-level leaders look to me to get support and answers from central finance."

Site and divisional CFOs can and should have responsibilities at both the local and system levels, with the system taking priority. Francioli believes that's a good thing: "We all have entity goals that we need to hit, but it's easier to achieve those goals when they are aligned with the system goals," he says.

Seeing things horizontally

Relationship-building across all areas is very important. When the introduction of goals leads to posturing or infighting, the well-positioned CFO can encourage teamwork and, ultimately, help achieve the goals.

Divisional CFOs can support local leaders in program development and growth initiatives. They play vital roles in conducting due diligence on mergers and acquisitions and typically are involved in joint ventures in their markets. They also must have exposure to other functional areas such as clinical integration, information technology, managed care negotiations, tax, treasury and supply chain. In short, they need to be involved in business development.

>> Read the full commentary at Hospital Impact