<h1 data-pm-slice="1 1 []">Chief Operating & Financial Officer (COFO)</h1> <p><strong>Backpack Healthcare | Hybrid/Remote | Preferred: MD, GA, IL, MI, or VA</strong></p> <h3>Build the Operating and Financial Engine Behind the Future of Behavioral Healthcare</h3> <p>Backpack Healthcare is on a mission to make high-quality mental healthcare more accessible to children, adolescents, young adults, and families who have historically been left out of the system.</p> <p>We are a <strong>Medicaid-first, venture-backed behavioral health company</strong> delivering whole-family telehealth care across Maryland, Virginia, Georgia, Michigan, and Illinois. With <strong>170+ clinicians, 219 employees, and more than 100 payer relationships</strong>, we are growing quickly while building a clear path to profitability.</p> <p>We are looking for a <strong>Chief Operating & Financial Officer (COFO)</strong> who is ready to help build what comes next.</p> <p>This is not a role for someone who wants to sit on the sidelines, analyze what happened, and prepare reports.</p> <p><strong>You will run the operating and financial engine of Backpack Healthcare.</strong></p> <p>You will own the numbers, own the outcomes, and lead the teams responsible for delivering both. You will work directly with our CEO and leadership team to turn data into decisions, decisions into execution, and execution into measurable results.</p> <p>If you are energized by complexity, move quickly, love solving hard problems, and want to have a direct impact on the trajectory of a growing healthcare company, this could be the opportunity for you.</p> <h2>What You'll Do</h2> <h3>💰 Own Financial Performance & Profitability</h3> <p>You will be accountable for Backpack's financial performance and the plan that gets us to sustainable profitability.</p> <ul data-spread="false"> <li> <p>Own budgeting, forecasting, monthly close, financial reporting, and GAAP-compliant financial operations.</p> </li> <li> <p>Build and manage the company's operating model, unit economics, and financial planning processes.</p> </li> <li> <p>Translate financial data into clear operating decisions and actionable priorities.</p> </li> <li> <p>Establish the financial discipline, visibility, and accountability required to scale.</p> </li> <li> <p>Serve as a primary financial voice to our board and investors.</p> </li> <li> <p>Present company performance, forecasts, risks, opportunities, and the path to profitability with confidence.</p> </li> <li> <p>Partner with the CEO on fundraising, including financial modeling, investor materials, diligence, and financing negotiations.</p> </li> </ul> <h3>💵 Own Revenue Cycle & Payer Economics</h3> <p>Revenue cycle isn't something you'll review from a distance. <strong>You'll own the results.</strong></p> <ul data-spread="false"> <li> <p>Take executive ownership of billing, collections, and revenue cycle performance across all states and payers.</p> </li> <li> <p>Drive measurable improvements in clean claims, denials, days in A/R, and cash collections.</p> </li> <li> <p>Analyze payer performance, reimbursement trends, and operational leakage.</p> </li> <li> <p>Partner with Growth and Partnerships on Medicaid and MCO pricing, bids, and rate negotiations.</p> </li> <li> <p>Identify opportunities to improve reimbursement, margin, and cash flow.</p> </li> </ul> <h3>🤝 Make Every Direct Contract Work</h3> <p>Every contract needs to make business sense.</p> <ul data-spread="false"> <li> <p>Model the economics and expected margin of direct contracts before they are signed.</p> </li> <li> <p>Build the operational and financial plan required for successful implementation.</p> </li> <li> <p>Establish staffing, onboarding, billing, and KPI requirements before launch.</p> </li> <li> <p>Track actual performance against projected economics after launch.</p> </li> <li> <p>Conduct post-launch reviews and take action when contracts miss targets — whether that means fixing operations, repricing, or renegotiating.</p> </li> </ul> <h3>⚙️ Lead Business Operations</h3> <p>You will connect the dots across the organization and ensure our systems actually work together.</p> <p>Your scope will include business operations, PMO, strategy and operations, credentialing, and care coordination.</p> <ul data-spread="false"> <li> <p>Establish clear KPIs for each function and review performance on a consistent cadence.</p> </li> <li> <p>Hold leaders accountable for measurable outcomes.</p> </li> <li> <p>Build scalable processes that support multi-state growth.</p> </li> <li> <p>Help prepare the organization for new market launches and expansion.</p> </li> <li> <p>Identify operational bottlenecks and eliminate them at the system level.</p> </li> <li> <p>Ensure that referrals, hiring, credentialing, scheduling, billing, contracts, and cash work together as one operating system.</p> </li> </ul> <h3>👥 Lead People & Administration</h3> <ul data-spread="false"> <li> <p>Provide executive oversight of the HR function, including tale