Why the CFO Role Is So Volatile

CFOs are facing increasing volatility in their roles, with shorter tenures and growing pressure to manage expanding responsibilities.

Today’s healthcare environment is turbulent, and the CFO’s seat is more precarious than ever. Recent data and executive insights make clear why they’re experiencing career churn, widespread burnout, and intensifying expectations.

For CFOs, survival requires new strategies, sharper skills, and broader alliances.

The Numbers: Short Tenures, High Turnover

According to a Crist Kolder Associates Volatility Report, the average tenure for a CFO in healthcare is 4.8 years, putting it fourth among other industries, ahead of sectors like Energy and Industrial but lagging behind Financial, Technology, and Services.

In addition, the CFO turnover rate climbed to 14.2% in the first half of 2024—a three‑year high. CFOs are also increasingly moving into CEO roles, yet many are leaving the industry r because of mounting pressures. Some are retiring, but others are pushed out by performance concerns.

Why the Role Is Increasingly Unmanageable

Several converging trends are putting pressure on the CFO. One is the expanding scope of the role. CFOs aren’t just stewards of the ledger. They’re now expected to lead (or at least significantly influence) operational strategy, tech investments (including data analytics and automation), labor cost mitigation, payer contract negotiation, and decision‑making that affects clinical operations.

Economic and regulatory pressures are also consistent stressors. Shrinking margins, inflation, labor shortages, unclear reimbursement streams, and complex regulatory demands compress financial flexibility. Even small missteps can have big effects., And for CFOs in rural areas, the stakes are even higher.

Many CFOs say that while responsibility has ballooned, support, either in terms of structure, partnership, or information, is lagging. There's a disconnect between what CFOs need and what their organizational ecosystems provide. In today’s hectic healthcare climate they need to ensure they are not working in isolation, and can rely and be relied on by their immediate team, organizational partners, and external partners.

Finally, burnout is a top factor in CFO turnover. Because the stakes are higher, mistakes are more costly, and expectations are shifting constantly, many CFOs are reporting stress and burnout, and considering departure.

What This Means for CFOs

Given that the average CFO tenure is just shy of five years in healthcare, the question isn’t if volatility will hit, but when. This environment demands constant adaptation, resilience, and strategic foresight, and CFOs need strategies to thrive, not just survive.

To navigate these challenges, CFOs should consider building cross‑functional relationships. They should break silos by partnering closely with clinical leaders (CMOs, CNOs, etc.), operations, IT, and HR. This increases visibility, improves alignment, and helps avoid blindsides.

CFOs should also not be afraid to delegate. The finance office should be able to deliver clean, timely insights, not just numbers, but comprehensive narratives without constant hovering by the CFO. Build expertise in analytics, forecasting, and risk modeling to advance a strong finance team.

Soft skills are also important. It’s no longer enough to understand cash flow, regulatory risk, or capital structure. CFOs must communicate, negotiate, manage conflict, influence without authority, and maintain stakeholder trust.

“The CFOs of the future really do have to have that strategic knowledge,” says Bristol Hospital CEO Kurt Barwis.. “They may be smart, but you can't put them at the top of your organization if they have no people skills, no interpersonal skills, and most importantly, no self-awareness skills.”

Continuous learning and mentorship should also be a strategic imperative in the CFO playbook. The complexity of healthcare finance is increasing. CFOs who stay current on reimbursement models, regulatory changes, labor economics, technology, and leadership trends will have more options—and more leverage. Mentoring emerging finance leaders helps create organizational strength and helps prepare the next generation of leaders.

The CFO role may never be easy. But with intentional preparation, relational capital, and alignment with mission and leadership, it can become manageable—and even deeply rewarding.