Built to Stabilize. Scale. Exit.
Fractional CFO services for founder-led and PE-backed companies. The strategic finance partner who takes the seat, owns the numbers, and stays until the work is done... equal parts strategy and execution, for the founders and CEOs facing the decisions that define a company. The same approach that carried Medicx Health from three months of cash to a $95M acquisition.
One foundation. Three horizons.
The work changes with the moment... but every stage stands on the same financial foundation, built from day one.
The First 90 Days
Cash visibility, control of the numbers, and a clear read on where the money actually goes. The bleeding stops, and leadership gets a financial picture it can trust.
The Next 24 Months
A real operating model, disciplined pricing and unit economics, and FP&A that matures alongside the company... growth the model can actually carry.
The Next 36 Months
Clean data, defensible numbers, and a financial story that holds up to a sophisticated buyer... ready long before a deal is ever on the table.
Different horizon, same discipline... the foundation that makes each stage possible is built from the first day in the seat.
A narrow focus. The right kind of work.
I work with a small number of CEOs, founders, and PE operating partners at companies where finance has to do more than report... it has to lead. The common thread: stabilizing under pressure, scaling toward maturity, or positioning for a meaningful capital event or exit.
Funded & Founder-Led
Pre-Series A through Series B founders building real CFO discipline before the next capital event. Cash visibility, unit economics, board-grade reporting, and the financial infrastructure to support what's next.
Hyper-Growth & Scale-Stage
Funded companies scaling past founder-built finance into exit-ready infrastructure. Pricing, unit economics, FP&A maturity, and the operating discipline to sustain growth without breaking the model.
Turnaround & Exit-Ready
Companies under cash, margin, or covenant pressure, positioning for transaction in 24 to 60 months, or operating under PE ownership. Whether the first 90 days are about stabilization or the next 36 are about exit prep, the work runs on the same foundation... cash visibility, EBITDA discipline, and a financial story that holds up to PE and strategic diligence.
The right first step. When scope isn't yet clear.
Most CFO engagements start without a clear scope... the founder knows something is off but can't name it yet. The Pulse Check is built for that moment. 30 days. A structured read on Cash, Margin, and KPI maturity, ending in a prioritized action memo. If a retainer follows within 60 days, the fee credits against mobilization. If you already know what you need, the tier menu is below.
How the 30 days work.
Light on your team. Heavy on the analysis. One CEO or sponsor stakeholder, three focus areas, one final memo with prioritized actions.
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01Kickoff & Data PullWeek 1. Scope confirmation, data access, stakeholder alignment. First $2,500 invoiced at Kickoff (Net 7, non-refundable once Kickoff occurs).
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02Diagnostic WorkWeeks 2 to 3. Independent read on Cash position, Margin profile, and KPI maturity. Out-of-scope items quoted separately at $500/hr.
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03Findings Memo & ReadoutWeek 4. 5 to 10 page Findings Memo, prioritized action list, retainer recommendation. Final $2,500 invoiced on delivery.
Medicx Health: from three months of cash to a $95M exit.
When I joined Medicx Health as CFO in 2019, the company had three months of cash on hand and three years of declining revenue.
The first 90 days were stabilization. Cash bridge, working capital, lender communication, vendor triage. Got the company off the runway.
The next 24 months were the rebuild. New operating model, redesigned product-level P&L and pricing, eliminated company debt, modernized the financial infrastructure with NetSuite. Took the company from declining to record-setting revenue, with EBITDA expanding from break-even to 20%+ margins.
The final 12 months were the exit. Transaction prep, banker engagement, diligence management. Led the sale to OptimizeRx for $95M in October 2023.
Vouched for by CEOs, presidents, and operators.
Drawn from over 25 years of operator relationships across healthcare, insurance, technology, and services... CEOs, presidents, and senior executives I've partnered with directly.
Scott's ability to uncover data-driven insights is unparalleled. His relentless pursuit of accuracy and precision has significantly contributed to our company's success. His leadership has been instrumental in steering our company toward growth and stability.
Scott elevated the accounting and finance function to a whole new level. He created efficiencies, tackled complex issues, and enhanced the insights finance was able to provide. He played a key role in the eventual sale of the business, helping lead a successful exit and post-acquisition integration.
Scott was really good at challenging the status quo, and helping people understand downstream implications of decisions as they relate to the finances, optics, and financial health of the organization. He is passionate about driving change in healthcare, and that comes through.
Scott was a key member of the Select Customer team. He provided insightful analysis on a timely basis to help in decision making and management of the business. He helped me a great deal and I would recommend him strongly.
Scott is a strong analytical and financial partner. He always provided top notch insight and expertise. What made Scott unique amongst his peers was his high intellectual curiosity and desire to understand the business more deeply. He is an outstanding partner and would be an asset to any organization.
Scott made significant contributions to any endeavor he was engaged in. He possesses a rare combination of financial acumen, innovative thinking, and a collaborative style.
Scott is a very proactive, collaborative and effective business partner. Though always focused on bottom line goals, his overall business acumen enabled him to serve as a valuable resource in offering viable alternatives to reaching corporate goals. I would not hesitate in recommending Scott for a financial or other executive management position.
Scott played a critical role in assessing the costs and benefits of critical business initiatives to increase organizational effectiveness. He was particularly helpful in identifying KPIs to measure the impact of process and organizational changes. I highly recommend Scott to any organization interested in driving meaningful change to improve competitive advantage.
Scott possesses a remarkable depth of knowledge and expertise in FP&A. His strategic insights and analytical acumen were instrumental in guiding our team to success on numerous projects, including the pivotal role he played in the company's merger with OPRX.
Scott is one of the most disciplined, committed, and results-oriented people I have ever worked with. He has a great ability to uncover opportunities hidden in data and is driven to help the entire team succeed. Scott is a terrific judge of ability and talent.
Strategic and operational. Built around the data.
Senior finance done right is half thought partnership and half hands-on execution. I lean on data, a CFO operator's instincts, and modern tooling to make the financial picture clear... then move on it quickly.
Diagnose Before Prescribing
Every engagement starts with a structured assessment. Cash, unit economics, KPIs, and the gaps between current state and exit-ready. No generic playbooks.
Frame as the Operator
I've sat in the CFO seat through scaling, turnaround, and a successful exit. Recommendations come with the EBITDA, cash, and risk implications already worked through.
Leverage AI and Data
I use AI-assisted modeling and reporting to turn a month-end scramble into a same-week answer... scenario analysis, variance explanations, and board-ready output, produced faster than a traditional finance team can.
Build for the Buyer
Every financial decision is filtered through the question of how it shows up in diligence. Clean data, defensible numbers, and a story that holds up to PE and strategic scrutiny.
Founder & CFO
"Companies don't get sold for what they did. They get sold for what the buyer believes they can do next."
I'm a strategic CFO with 25-plus years of experience driving financial transformation, capital strategy, and operational scale across high-growth and complex organizations. I'm best known for the work that took Medicx Health from three months of cash and declining revenue to a $95M sale to OptimizeRx in 2023.
Through Magnano Advisory, I partner with a select group of funded, hyper-growth, turnaround, and exit-stage companies across healthcare, technology, insurance, services, and pharmacy benefit management (PBM). The work spans full acting CFO engagements, project-based financial transformation, and board-level strategic advisory. The common thread is always the same: building the financial infrastructure that supports scale and stands up to a sophisticated buyer.
What a founder actually gets is someone who has carried the weight before. I have sat in the chair when payroll was a question mark, when the board wanted answers I didn't yet have, and when a deal hinged on the numbers holding up under scrutiny. I take that pressure off the CEO's desk... direct about what the numbers say, straight about what I would do, and in the room as a partner, not a report.
I'm based in the Phoenix area, work nationally, and partner with founders, CEOs, boards, and PE operating partners across the country.
Notes from the CFO seat.
Perspective on exit strategy, FP&A, capital structure, and the realities of scaling a private company toward transaction. New writing every week or two.
Healthcare Capital Raise: Why Most Decks Fail in Round 2
The story that won your Series A won't win your Series B. The four ways healthcare Round 2 decks fail underwriting in 2026... and the model work that clears the filter.
Read →What Bankers Want in a Seller's CFO
After leading finance through a $95M healthcare exit, the five things bankers wish more sellers' CFOs got right before mandate. Clean numbers, owned data rooms, and forward models you'd defend in deposition.
Read →The $40M Ceiling: Where Founder-Built Finance Stacks Break
Almost every founder-built finance stack breaks somewhere between $20M and $40M in revenue. Three failure modes that always show up... and what to replace them with before the next capital event.
Read →Answers before the call.
The questions that come up on every discovery call... answered up front so they don't have to.
How is this different from hiring a full-time CFO?
What's the difference between your retainer tiers?
What does a CFO advisory engagement cost?
Why a 90-day initial term?
How do you structure and price engagements?
What if I'm not sure which tier is right?
Can I skip the Pulse Check and go straight to a retainer?
Do you only work with healthcare and PBM companies?
How do you handle confidentiality and conflicts of interest?
What's the mobilization fee for?
What happens when the engagement ends?
How quickly can you start?
Let's talk about what's next.
Book a 30-minute diagnostic call.
Pick a time that works. No prep needed. We'll talk about where the business is and where it's going.
Book a Diagnostic Call →Prefer to write first? Use the form on the right. The first conversation is a no-cost 30-minute diagnostic call. We'll talk about where the business is, where it's going, and whether what I do is the right fit. If it is, we'll scope from there. If not, I'll point you to someone who is.