Our team of healthcare practitioner consultants is dedicated to improving the financial health of your organization. Meet your new team!

DOUG FENSTERMAKER

Managing Partner and Sr. CFO

Doug has 35 years of healthcare experience, primarily in executive management and senior leadership positions. Doug has functioned successfully as a managing partner in several roles including his present role as leader of the CFO Consulting Network within Warbird’s Healthcare Practice. He has also performed as a Sr. CFO (interim) and Sr. Financial Advisor to hospital and system clients. He has provided expertise in financial turnarounds and in margin and performance improvement efforts. Doug also assists Warbird Healthcare in business sales origination and client network relationships. He joined Warbird Consulting Partners as its Healthcare Managing Parter in January 2012.

Professional Experience

In 1999, Doug joined Stockamp & Associates as a partner and managing director. Stockamp was acquired by Huron Consulting Group in 2008. Prior to his tenure at Stockamp, Doug’s career included 18 years of experience as a CFO, including work for the HealthEast Care System in St. Paul, Minnesota and at Good Samaritan Hospital within the Legacy Health System in Portland, OR. While at Legacy, Doug also served as Corporate Senior Vice President for Managed Care and Revenue Management.

Doug has a BA in Economics from the University of California, Santa Barbara and a Master of Public Administration (Financial Planning) from California State University, Long Beach.

CONTACT

Email: dfenstermaker@warbirdcp.com

EDUCATION AND CERTIFICATIONS

Bachelor of Arts, Economics; University of Southern California, Santa Barbara
Master of Public

Administration (Financial Planning); California State University, Long Beach

PROFESSIONAL ASSOCIATIONS

Healthcare CFO Roundtable, member since 1993

Healthcare Management Academy, member since 2001

American Hospital Association, executive liaison since 2007

DOUG FENSTERMAKER
Managing Partner and Sr. CFO

JAMES FOX

Director and Senior CFO Consultant

James is an accomplished senior executive with a strong record of success in building, developing and managing all aspects of financial operations for complex organizations, academic institutions and small growth companies. He is recognized as being strategic, creative and results-oriented, with a proven ability to engage teams in effectively achieving their goals.

Professional Experience

Prior to joining Warbird’s CFO Consulting Network, James served as CFO for Fairview Health Services.

A career healthcare finance expert, James:

  • Managed all aspects of finance during a 16-year period that saw the company grow to $2.8 billion from $ 0.5 billion, including the addition of academic medicine
  • Led the company’s strategic planning and goal development, which was utilized by the board of directors in recruiting a new CEO
  • Developed and implemented an enterprise risk management process for financial, operational and environmental risk
  • Developed metrics and measurement processes to create a clear understanding of performance expectations for transplants and quaternary care services, acute care services, physician services, HMO and health plan services, retail and specialty pharmacies, and other healthcare related entities
  • Managed more than 1,000 people in cross-functional areas, including accounting, payer contracting, supply chain, information systems, revenue cycle and risk management
  • Developed self-insurance programs, including professional and general liability, workers compensation, employee health insurance, excess professional and general liability, and other employee benefit programs
  • Developed companies to market products to employers and Medicare/Medicaid managed programs for HMO, insurance and third party administrators
  • Led the acquisition of the University of Minnesota Hospital and Clinics (700-bed academic hospital), Columbia Park Medical Group (70-person multi-specialty clinic), and other hospitals and clinics
  • Led a process improvement initiative that reduced A/R to 48 days from 68 days
  • Operationalized a captive insurance company that created savings of more than $2 million annually through self-insurance programs
  • Successfully sold more $700 million in tax exempt bonds over the last three years
  • Identified cost-saving opportunities that reduced corporate costs by a third – to eight percent from 12 percent of revenues
  • Reorganized to reduce supply costs to 13.4 percent of revenues, benchmarking in the top 25 percent according to the national database
EDUCATION AND CERTIFICATIONS

Bachelor of Science, Accounting; St. Cloud State University, St. Cloud, MN

Certified Green Belt in Six Sigma; Carlson School of Business, University of Minnesota, Minneapolis

Certificate of Completion for executive course on system thinking; Society of Learning, Massachusetts Institute of Technology

PROFESSIONAL ASSOCIATIONS

Member, Hospital Finance Management Association

Chairman of the board and president, Associated Medical Assurance

Board member and chair of Finance Committee, American Excess Insurance Exchange

Member, Ebenezer Society

Board member, Fairview Pharmacies

Board member, Institute of Athletic Medicine

Board member, PreferredOne

JAMES FOX
Director and Senior CFO Consultant

JAMES GRAVELL

Director and Senior CFO Consultant

Jim is a senior healthcare executive with nearly 30 years’ experience in guiding the strategic and operational direction of integrated healthcare systems.  A proven leader with a diversity of experience, an understanding of the challenges facing healthcare and the array of approaches to their solutions. A bias for action and building strong leadership teams.

Professional Experience

Prior to joining Warbird‘s CFO Consulting Network, Jim served as the CFO for Catholic Health Partners (CHP), a $5 Billion, faith-based, healthcare system that operates over 20 hospitals in 2 states as well as long-term care, home health and hospice programs. Jim was a Chief Operating Officer and Interim regional CEO during his 14 years with CHP. Prior to joining CHP, Jim was a Finance Vice-president for Adventist Health Systems (AHS) where his 15 year career saw a steady progression of responsibility from controller of Florida Hospital to a regional CFO and corporate vice president. Over the 30 years in healthcare he accomplished the following:

  • Raised the question that lead in part to a strategic assessment of the company’s portfolio that moved the organization to a more geographically centric strategy rather than as broad a multi-state approach.
  • Redefined the governance finance oversight process to focus on four key elements of success that balance operational and strategic expectation while merging these into the rating agency and capital planning processes. The organization has been recognized as a best practice for its governance and investor disclosure processes.
  • Participated in the negotiations of several $250 million plus sales/acquisitions that repositioned the organization for the more geographically centric strategy that better positioned it for population health and the Health Exchanges.
  • A key member of the negotiating team that resulted in a breakthrough in the approach to establishing market presence increased state market share by over 20%.
  • The key financial leader in the acquisition of Kaiser Permanente – Ohio that positioned the organization for population health and the role of a health plan, physician and acute operations in that solution.
  • Focused fiscal strategy on the interdependent nature of the investment, insurance, debt and pension strategies to optimize financial flexibility.
  • Moved from a defined benefit (DB) to a defined contribution (DC) pension plan with the DB plan nearly 100% funded.
  • Presented to rating agencies, investment bankers and insurers and annual investor conferences.
  • Resolved bond covenant compliance issues that rose out of the 2007-2008 financial meltdown.
  • Standardized and centralized the finance operations of a $5 billion health system improving services while reducing cost by over 15%.
  • Redefined the financial planning process that resulted in a five year strategic, capital and operating and forecasting approach that focused management on longer term objectives and short term opportunities. Strategy and operations were significantly influenced by this process.
  • Transitioned revenue cycle to a partial outsourced model that reduced capital cost by $30 million and will move costs to the 90th percentile.
  • Refocused the organization from building a new hospital to developing the ”Optimal Health Solution” for the community focused on an outpatient and physician partnering strategy.
  • Led staffing operational initiatives that became the approach for the organization reducing cost by over 20% with quartile to decile results.
  • Redefined the supply chain management process, decreasing costs to below quartile benchmarks.
  • Facilitated numerous operational turnarounds.
  • Balanced operational and strategic needs by implementing a capital allocation process that incorporated maximized opportunities while focusing on strategy and mission objectives.
  • Led the implementation of an organization wide managed care contract management system.
  • Developed and implemented one of the first organizational wide healthcare cost accounting systems in the country
EDUCATION AND CERTIFICATIONS

M.B.A. – University of Nebraska, Lincoln

Certified Public Accountant, 1983-94

PROFESSIONAL ASSOCIATIONS

Healthcare Financial Mgmt Association (HFMA)

Former Adjunct Professor, Xavier University

HFMA Large System CFO Council

JAMES GRAVELL
Director and Senior CFO Consultant

STEPHEN PICKETT

Director and Senior CFO Consultant

Stephen has over 25 years of broad-based Executive Healthcare experience. He possesses a unique blend of operational and financial management exposure in both teaching hospitals and community healthcare organizations. Stephen has the proven ability to manage a wide range of responsibilities while advising and steering major strategic decisions. His leadership and negotiation skills are exceptional in the healthcare space. Stephen’s specific expertise lies in administration, finance, operations and strategy. He has led numerous initiatives in positions with various health systems and hospitals that have resulted in millions of dollars in savings. An outstanding healthcare professional, Stephen can make an astonishing positive contribution to any professional team.

Professional Experience

Prior to joining Warbird‘s CFO Consulting Network, Stephen served as Executive Vice President, EVP and Chief Financial Officer of St. Luke’s Episcopal Health System. He has also served as EVP and CFO of UAB Health System, President & CEO of Tulane University Hospital & Clinic and EVP & Administrator of West Virginia University Hospitals where he accomplished the following:

  • Responsible for operations of a healthcare system that included six hospitals (both Not-for-Profit hospitals and For-Profit joint venture hospitals), an IPA, community emergency centers and affiliations with Baylor College of Medicine and the Texas Heart Institute with net revenues of over $1.2 billion with 1,000+ physicians and 6,000+ employees
  • Served as key member of the management committee during strategic planning review by Board that led to a sale of a system
  • Served as Chair of the Board for four community hospitals
  • Served as Chair of the Epic Executive Steering Committee for a system
  • Initiated process to select an ambulatory surgery partner for a system
  • Responsible for financial oversight of two community hospital CEOs, the CIO, Human Resources, Managed Care Contracting, international services, supply chain, internal audit/compliance and all financial areas
  • Served as the Executive in Charge in absence of the system’s CEO
  • Participated in rapid system expansion strategy resulting in opening of a new physician joint venture hospital
  • Proposed and led negotiations for acquisition of 51% of Patients Medical Center
  • Initiated System wide RFP process for dietary, housekeeping and biomedical services; new contract resulted in $6 million in annual savings
  • Led initiatives for supply chain changes that resulted in over $7 million in savings. Contract compliance increased by 139% and non-catalog orders decreased by 30%
  • Responsible for financial oversight of a system that includes seven hospitals, three ambulatory surgery centers, home health services, on-campus and satellite clinics, joint ventures, large physician practice plan and insurance company Viva Health. Net Revenues of over $2 billion with 1,000+ physicians and 10,000+ employees. Responsible for all administrative and financial areas including human resources and information systems
  • Negotiated and managed the establishment of health care authorities (HCA) for organizations
  • Negotiated and managed the asset purchase agreement of a Medical Center campus consisting of 219 licensed bed hospital, two professional office buildings, and other improvements on the 17+ acre campus
  • Served as Chief Restructuring Officer during interim management agreement, leading successful waiver of default for the organization, while negotiating plan of finance to open a three year cash flow window allowing for capital reinvestment in the facilities
  • Led successful financing plan and bond issue for $275 million hospital project
  • Successfully negotiated key issues with medical staff related to new hospital project and other funding issues
  • Initiated and led process to review University’s administrative cost allocation to hospital. Negotiated changes resulted in $2.5 million annual savings
EDUCATION AND CERTIFICATIONS

Masters – Concentration in Public Health, Tulane University

B.B.A. Degree – University of Montevallo

PROFESSIONAL ASSOCIATIONS

American College of Healthcare Executives

Fellow, Healthcare Financial Management Association

American Institute of Certified Public Accountants

STEPHEN PICKETT
Director and Senior CFO Consultant

MICHAEL RUTHERFORD

Director and Senior CFO

Mike is a senior Healthcare professional with a 30+ year career and a proven track record of accomplishments in Financial and Operational leadership roles within large Academic Medical Centers and Integrated Healthcare Systems. He has specific expertise in Strategic & Financial Planning, Managed Care Contracting, Physician Alignment, Revenue Cycle, M&A and Expansion. Mike has quality leadership skills and the ability to develop strong management teams. His communication and presentation skills are exceptional.

Professional Experience

Prior to joining Warbird‘s CFO Consulting Network, Mike served as the CFO for The Ohio State University Wexner Medical Center, a $2.7 billion health system. Prior to joining OSU, Mike was System Vice President and CFO for Summa Health System for 11 years. Prior to Summa, Mike was CEO and CFO of the Cleveland Market for Sisters of Charity Health System (SCHS) and VP of Operations at Sharon Regional Health System. Over the 30 plus years in healthcare he accomplished the following:Directed all financial activity for a $2.7B net revenue academic medical center, including: College of Medicine, 1100 physician Faculty Group Practice, 6 hospitals, comprehensive cancer center, full service tertiary referral center,  Health Plan and  a network of Outpatient Centers

  • Created a consolidated long range financial plan to model Health Reform scenarios and identify strategies necessary to adapt  to establishment of health exchanges, mandatory insurance coverage, expansion of Medicaid, and increasing pricing transparency, resulting in a 5 year expense reduction goal of $100M per year
  • Served on task force to respond to Health Reform impact  including the establishment of an ACO, development of alternative payment arrangements, and expansion of Health Plan into a statewide network with commercially viable products
  • Developed the 1st consolidated financial statements, combining  College of Medicine, Faculty Group Practice and hospitals, allowing management to view organization as a single entity and facilitate decision making
  • Served on task force to evaluate opportunities and develop statewide growth strategy, including negotiations to partner with another $1B healthcare system
  • Implemented consolidated managed care contracting, integrating 3 entities: cancer center, hospitals and physicians. Facilitated improved payor relationships and increased reimbursement rates
  • Implemented Epic Revenue Cycle applications for all entities. Directed software  training  of 2000+ staff
  • Led Medical Center through its 1st stand-alone external audit with zero adjustments to income statement or balance sheet
  • Directed financial activity and expansion of an integrated healthcare delivery system. Grew from 1  hospital and an insurance company to a $1.8B revenue, 11,000 employee system with: 6 hospitals, a multi-state insurance company, preferred provider network with 30,000 physicians, 204 hospitals jointly owned with a faith-based system, statewide DME company, 1100 member PHO,  off-shore insurance captive and 8 physician joint ventures
  • Developed financial plan to strengthen balance sheet. Maximized cash growth and minimized long-term debt, allowing for growth and investment in expansion opportunities and core operations. Sustained a debt-to-net revenue of 20 %
  • Utilized alternative financing techniques, including synthetic leases, off-balance sheet and developer financing to maintain balance sheet strength while accomplishing strategic goals. Maintained conservative debt structure and avoided setbacks in recent tumultuous financial market
  • Established system-wide investment committee and recruited top industry talent to serve on a volunteer basis and advise on appropriate risk-adjusted investment policies for each of the system’s investment pools.  Monitored performance and revising strategies as necessary
  • Implemented cost accounting system across each entity to track profitability by service line and physician, enabling organization to execute immediate action plans to address deficiencies
  • Developed monthly financial variance reporting tools at dept. level to identify/correct operating deficiencies. Hospitals consistently ranked in bottom 10% in expense/adjusted admission compared to their peers
  • Doubled EBITDA in 24 months in recently acquired, previously proprietary owned hospital
  • Enacted multi-year $100M strategic plan for IT rollout beginning with full CPOE implementation at main tertiary facility
EDUCATION AND CERTIFICATIONS

M.B.A. – Finance, West Virginia University

B.S. – Business Administration, West Virginia University

MICHAEL RUTHERFORD
Director and Senior CFO

PAMELA VUKOVICH

Director and Senior CFO Consultant

Pamela is an experienced healthcare executive with a proven record of setting and achieving high standards. She has worked at hospitals with net operating revenues of more than $1.4 billion. Pamela has an extraordinary ability to develop and execute innovative solutions to operational and administrative challenges and is an effective leader and workforce developer. She has a proven ability to manage a breadth of responsibilities beyond finance functions and has an unwavering commitment to the mission of service.

Pamela’s background consists of a variety of different responsibilities including real estate management, managed care contracting, reimbursement (working with government payers), financial analysis, budgeting, internal audit, accounting, purchasing, materials management, maintenance of an integrated employee leave program and overseeing the employee health program. She began her career at KPMG as an auditor.

Professional Experience

Prior to joining Warbird‘s CFO Consulting Network, Pamela served first as CFO and then as the interim president and CEO of Legacy Health System.Prior to that, she served as vice president of finance and controller of Good Samaritan Hospital, where she advanced to vice president of finance for all hospital operations. Recognized as an ambitious finance professional, while at Legacy Health System, Pamela:

  • Assisted in maximizing government reimbursements resulting in significant increased cash flow in a three-year period
  • Completed numerous bond transactions for both new money and refunded money
  • Oversaw corporate and retirement plan investments  totaling more than $1.2 billion
  • Directed process changes in group purchasing organizations in 2005 and 2010 that resulted in more than $6 million in supply savings for the organization
  • Developed long-term plans for succession of all key leadership positions in her areas of responsibility, including CFO and vice president of finance
  • Led the organization to voluntarily adopt the applicable sections of Sarbanes-Oxley regulations governing the ethical performance of corporations
  • Conducted the internal audit review of financial reporting controls that enabled the CEO and CFO to certify the financial statements
  • Developed capital process for the system including electronic approvals, tracking and monitoring
  • Formed a decision-making body that included stakeholders from throughout the organization to review and prioritize capital purchases based on objective criteria
  • Reorganized and transitioned the risk management function from a claims management function to claims avoidance and loss prevention function
  • Restructured the insurance program, including the development of a captive insurance company, in order to work directly with reinsurers
  • Developed a robust cost accounting system in order to analyze and prioritize programs within the organization and identify clinical procedures with opportunities for improvements
  • Led the planning, construction and financing of a children’s hospital and a community hospital; projects completed on time and on budget
  • Managed the business functions of the consolidation of clinical programs and facilities
  • Directed the transition of investment options for employees in the defined contribution plans from a paper platform to an electronic platform
EDUCATION AND CERTIFICATIONS

Bachelor of Science in Business; Oregon State University

Certified Public Accountant, Oregon

PROFESSIONAL ASSOCIATIONS

Member, American Institute of Certified Public Accountants

Member, Oregon Society of Certified Public Accountants

Member, Healthcare Financial Management Association

Health Management Academy, Executive-In-Residence

PAMELA VUKOVICH
Director and Senior CFO Consultant

ROBERT WARDWELL

Director and Senior CFO Consultant

Robert is a seasoned healthcare executive with over 30 years’ experience in the areas of finance, operations and strategy. He has significant experience in teaching clinical and non-clinical leaders to become CEO of their operations. Robert has a proven ability to lead organizational change using lean tools and methods. He is skilled in strategic planning, lean implementation, treasury and debt management, physician relations, contract negotiations and management. Robert also has expertise in managed care organization, capitation, revenue cycle management and M&A.

Professional Experience

Prior to joining Warbird’s CFO Consulting Network, Robert served as Vice President of Finance, CFO for Dignity Health Southern California Service Area, Vice President of Finance, CFO for Tri-City Healthcare District and Senior Vice President, Finance for Schumpert Health System.  At these hospitals and health systems he accomplished the following:

  • Formation of a clinical integration network with 250 physicians
  • Improved labor & supply expense by 12%
  • Completed a significant restructuring of the revenue cycle taking net days in A/R from 90 to 45
  • Trained management staff in effective utilization of financial/statistical/operational reporting
  • Reduced payer denials by 75% in the first 18 months ($3 million)
  • Completed a revenue cycle improvement review of a 350,000 plus visit ambulatory care system and identified several million dollars of improvement opportunity
  • Developed a comprehensive system involving detailed metrics to drive performance
  • Reorganized managed care contracting and achieved millions of dollars of improvement
  • Recouped in excess of $10 million from Medicare for past cost reports filed
  • Established labor productivity standards and installed a robust monitoring system to insure appropriate utilization of labor yielding $11 million in savings in 18 months
  • Assumed a lead role in developing a long-term strategic plan & a plan of finance to address the medical centers future growth and success including completion of a total debt restructure
  • Built a first class customer focused financial team and successfully managed the organizations investment portfolio exceeding established benchmarks
  • Recruited over 40 physicians and managed a MSO that handled billing for over 75 physicians
  • Helped to establish a PHO that included more than 300 physicians covering virtually all specialties
  • Initiated a “Product Standardization” team which achieved significant supply cost savings ($2 million)
  • Managed capital expansion projects in excess of $250 million.
  • Managed an investment portfolio in excess of $150 million consistently exceeding ROI benchmarks
  • Played a key leadership role in the implementation of an organization-wide TQM/CQI program that yielded significant cost savings and quality improvement
  • M&A experience via the sale of the hospital twice, once to a non-profit and once to a for profit organization
  • Instrumental in new product line development with in and out patient components: Diabetes Center, Arthritis Center, Skilled Nursing Unit, Chest Pain E.R., Neurosurgery Program
EDUCATION AND CERTIFICATIONS

B.S. Degree – Major in Accounting and Finance, Northeastern University

PROFESSIONAL ASSOCIATIONS

Advanced Member, HFMA

Associate, ACHE

ROBERT WARDWELL
Director and Senior CFO Consultant

ROBIN NICHOLS

Director and Sr. CFO Consultant

Robin is a Senior Healthcare Finance professional with more than 30 years of extensive experience in operational responsibilities, strategic planning, and financial management. Her experience includes but is not limited to various aspects of healthcare operations: physician practices, hospitals ranging in size from major teaching, community, long-term care, critical access, behavioral health, outpatient facilities, governmental, rural, and ambulatory care. Robin has proven expertise in improved revenue cycle, debt restructuring, treasury management, IT integration and managed care negotiations. She is a decisive, results-oriented leader with proven results in healthcare management.

Professional Experience

Robin has considerable professional experience serving in positions of financial leadership in the healthcare industry. Before joining Warbird Consulting Partners, she served as Director of Revenue Cycle for Athens Regional Health System; CFO at Harnett Health System; CFO at Coshocton County Memorial Hospital; CFO and VP of Finance at Eagle Hospital Physicians, LLC; CFO and VP of Finance at Major Hospital; CFO at Greene Health Partners; and Director of Revenue and Statistical Reporting at Meridia Huron Hospital.

  • Interim CFO (and prior Director of Finance) for a 210 bed hospital and 400 bed hospital which included distinct Behavioral Health units.
  • As acting CFO was Administrative leader for Electronic Medical Record installing of Meditech and LSS for a JCAHO accredited, full-service acute-care hospital, met with all physician; corrected outsourcing arrangements, expanded coding expertise, and established formal hospitalist program with physicians.
  • Managed privately held Hospitalist company with 130 fulltime physician and 125 part time physicians; responsible for strategic planning, overseeing all finance functions, physician billing, and compliance plans. Successfully improved contracts on poor performing accounts, setup new software strategy for payroll, GL, billing and core system design, and created meaningful reports for Chief Medical Officer, VP of Physician practices site.
  • CFO and VP Finance of a community hospital jointly owned by city/county commissioners with net revenues of $86M licensed for 95 beds, foundation, for-profit pharmacy, five physician groups, onsite clinic and software company; assumed financial reporting of physician practices and charged with hiring a team to support the effort.
  • Worked with a community hospital licensed for 210 beds with distinct units to obtain capital funding which enabled investment for expansion, streamlined revenue cycle, and facilitated physician contracting to enable model of practice to fit physician whether employment arrangement or independent model.
  • Managed relationships of emergency physicians and anesthesia contracts, reviewed insurance contracts for wording and financial feasibility and PHO to take capitation risk, and converted to new IT system, including rebuilding reports and GL structure.
  • Functioned as Director of Revenue and Statistical Reporting for a major teaching 395 bed hospital along with 3 other hospitals total beds just under 1,000.
  • Analyzed, maintained, and improved internal control over the fiscal assets for the hospital. Provided guidance, analysis and review of the activities of general accounting, payroll, cashiers and financial analysis and reporting.
  • Led conversion of Time and Attendance system, streamlined monthly closing process, established protocol for reimbursement analyst to perform audits of patient bills, and standardized dashboard reports for system hospital executives.
  • Led Computerized Physician Order Entry (CPOE) implementation for meaningful use monitoring.
  • Improved coding at clinical practice sites by setting schedules for performance of coding staff and meeting monthly with operations members on key initiatives.
  • Attended site locations as support for contract issues or training of physician staff.
  • Improved net revenue by 15% with strategic pricing, installation of automated supply charging system.
  • Served on Medical Advisory Board and assisted in clinical pathway development, resulting in a decrease of average length of stay by one half day.
  • Converted to new IT system, including rebuilding reports, GL structure.
  • Involved in establishing package pricing for cardiac services with clinical directors across all hospital units.
ROBIN NICHOLS
Director and Sr. CFO Consultant