Financial Leadership for Community Health Centers: What every Federally Qualified Health Center (FQHC) CFO needs to know to lead finance, strategy, and compliance

Financial leadership in a Community Health Center is not the same as traditional healthcare finance—and most resources don’t reflect that reality.

This book was written specifically for Chief Financial Officers and financial leaders in Federally Qualified Health Centers (FQHCs) who are responsible not just for managing numbers, but for leading through complexity, compliance, and constant operational pressure.

Drawing on more than 30 years of experience as a CFO, consultant, and federal site visit reviewer, Cris Julian provides a practical, field-tested guide to the financial leadership challenges that health centers actually face.

This is not a textbook. It is a real-world playbook.

Inside, you’ll learn how to:

• Strengthen your revenue cycle beyond basic billing metrics
• Build budgets that reflect operational reality—not just assumptions
• Identify where financial oversight breaks down, even when audits are clean
• Manage contracts and subawards with compliance and clarity
• Establish internal controls that work in real-world staffing environments
• Communicate financial performance in a way that leadership and boards understand

Whether you are stepping into a CFO role for the first time or refining your leadership approach, this book provides the structure, clarity, and insight needed to lead financial operations with confidence.

Because in a Community Health Center, finance isn’t just about reporting results—it’s about ensuring the organization can continue to serve.