Magnano Advisory | Fractional CFO

Who I Help

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.

— 01

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.

Pre-Seed–Series B Founder-Led Capital Prep

— 02

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.

Funded & Scaling $3–50M Revenue Operating Maturity

— 03

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.

Turnaround Exit Prep PE-Backed

Trigger Moments

When companies typically call.

Revenue has scaled faster than finance infrastructure

Forecasts no longer feel reliable to leadership or investors

EBITDA lags despite top-line growth

Pricing and reporting lack discipline

Leadership lacks actionable financial visibility

Board reporting has become reactive, not strategic

Cash pressure is building under growth

Diligence, capital raise, or exit is on the horizon

Functional teams are misaligned on KPIs and accountability

The CEO has become the de facto finance function

Industry Expertise

Deep operator experience across healthcare, technology, insurance, services, and pharmacy benefit management (PBM). Comfortable with both regulated and unregulated complexity, payor and provider economics, subscription and transactional revenue models, and the data infrastructure required for each.

The On-Ramp

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.

Strategic Finance Pulse Check

The Strategic Finance Diagnostic

A clean read on where you stand. In 30 days.

$5K

fixed fee · 50/50 split · Net 7

Timeline

30 days from Kickoff

Scope

Cash, Margin, KPI

Deliverable

5–10 page Findings Memo

Stakeholder

Single CEO / sponsor

Mobilization Credit

100% of the $5K fee credits against the mobilization fee on any retainer tier signed within 60 days of memo delivery. If we engage further... the diagnostic effectively pays for your mobilization.

Schedule a Call → Contact Me

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.

01

Kickoff & Data Pull

Week 1. Scope confirmation, data access, stakeholder alignment. First $2,500 invoiced at Kickoff (Net 7, non-refundable once Kickoff occurs).
02

Diagnostic Work

Weeks 2–3. Independent read on Cash position, Margin profile, and KPI maturity. Out-of-scope items quoted separately at $500/hr.
03

Findings Memo & Readout

Week 4. 5–10 page Findings Memo, prioritized action list, retainer recommendation. Final $2,500 invoiced on delivery.

Standalone engagement. No MSA required. Two signatures... proposal + SOW... and we ship in 30 days.

After the Diagnostic

Three retainer tiers. One menu of project work.

Engagements are flat-fee, scoped, and outcome-driven, so conversations stay strategic and your costs stay predictable. Retainers come with monthly cadence; projects come with defined deliverables and timelines.

Foundations

The Strategic Finance Partnership

Strategic finance visibility within 90 days.

Bi-weekly cadence · Senior CFO partnership

$5,000/mo

Starting investment · Mobilization fee separate

Best for: Founder-led companies needing strategic finance visibility and a senior CFO sounding board, with existing accounting support.

Bi-weekly CEO/founder touchpoint
Monthly executive financial review with written summary
Variance commentary on existing reporting package
Rolling 13-week cash flow forecast (build + monthly refresh)
Lightweight KPI tracker (build + maintain)
Annual budget review and challenge with written commentary
Quarterly cash flow review and forecast refresh
Ad-hoc analysis within engagement scope

Inquire

Most Common

Growth

The Operating Partnership

Operating cadence and board-grade reporting within 6 months.

Weekly engagement · Embedded operating partner

$10,000/mo

Starting investment · Mobilization fee separate

Best for: Companies actively scaling toward a capital event, operational maturity, or institutional financing.

Everything in Foundations
Monthly close review and full reporting commentary
Cash flow forecasting (short-term and long-term)
Dynamic KPI dashboard maintenance
Annual budgeting and reforecasting
Pricing and margin analysis (tactical)
Lender and investor relations support

Inquire

Board-Ready

The Transaction Partnership

Transaction-ready financials and equity story within 12 months.

Multi-touch weekly · Full CFO oversight

$15,000/mo

Starting investment · Mobilization fee separate

Best for: Companies positioning for transaction in 12 to 36 months, or operating under PE ownership.

Everything in Growth
Full board financial package authorship
Multi-scenario forecasting and stress modeling
Capital strategy and transaction prep oversight
Lead role with bankers, lenders, and board
Strategic pricing and unit economics
M&A pipeline and diligence support

Inquire

Premium · Custom Engagement

Acting CFO

The Interim CFO Engagement

Near-full-time CFO presence for the work that doesn't fit a weekly cadence.

Daily/near-daily availability · 3 to 6 month initial term

$25K–$45K/mo

Scoped case by case

Inquire

Best for: Companies in active turnaround, intensive transaction prep, or covering an interim CFO gap before a capital event. Pricing reflects situation severity and required intensity.

Daily or near-daily CFO presence
Lead role with bankers, lenders, PE sponsors, and board
Cash bridge, working capital, and covenant management
Transaction prep, diligence leadership, or turnaround execution
Direct supervision of internal finance team or controller
13-week and long-range forecast ownership
Board-grade reporting and investor relations
Custom scope sized to situation severity

Engagements outside these tiers... lighter-touch advisory, project-only, or custom hybrid scopes... are available on request and scoped after a no-cost diagnostic call.

Problems We Solve

Outcomes. Not functions.

What the engagement actually delivers... not what the org chart says.

— 01

EBITDA Expansion

Margin discipline through pricing, mix, and operating leverage

— 02

Forecasting & KPI Infrastructure

Driver-based models leadership and investors can trust

— 03

Cash Flow Visibility

13-week and long-range cash, with covenant and runway management

— 04

Pricing & Unit Economics

Product-level P&L, segmentation, and pricing discipline

— 05

Board & Investor Reporting

Strategic packages that move conversations forward

— 06

Transaction Readiness

Diligence prep, banker management, equity story

— 07

Strategic Planning

Multi-year operating plans tied to capital strategy

— 08

Finance Team Scaling

From founder-built to institutional-grade finance org

Project Engagements

Defined scope. Defined deliverables.

Project engagements pair well with retainers or stand alone. Where a range is shown, it moves with scope, company size, and data readiness... the cleaner the starting point, the lighter the lift. Final fee is set after a no-cost diagnostic call.

— 01

Diagnostic & Systems

Structured assessments and systems oversight to identify gaps and modernize finance infrastructure.

Strategic Finance Pulse Check ↑ Featured Above

30 days · Cash, Margin, KPI diagnostic + Findings Memo · 100% Mobilization Credit

$5K

ERP Selection & Implementation Oversight

NetSuite, Sage Intacct, or comparable

$20–40K

— 02

Build & Operate

The financial infrastructure required for scale, board reporting, and operational discipline.

13-Week Cash Flow Model

Rolling weekly forecast with refresh protocol

$7.5K

KPI & Reporting Dashboard Build

KPI architecture and dynamic dashboard in client tools

$10–15K

Annual Budget Build

Driver-based budget, monthly phasing, departmental P&Ls

$12–18K

Board Reporting Package Setup

Deck design, KPI architecture, narrative, first-quarter package

$12–20K

Financial Model Build or Refresh

Driver-based, scenario-ready, board-grade

$15–30K

— 03

Strategy & Pricing

The forward-looking strategic work that translates financial insight into value creation.

5-Year Proforma & Strategic Forecast

Opinionated forward view, scenario modeling, capital strategy

$20–35K

Pricing & Unit Economics Deep Dive

Same playbook used at Medicx... break-even to 20%+ EBITDA

$20–35K

— 04

Capital Events & Transactions

Transaction-grade preparation, diligence, and execution support for liquidity events.

Capital Raise Support

Modeling, deck, lender or investor narrative

$25–50K

Quality of Earnings Preparation

Sell-side QoE prep, pre-diligence cleanup, adjustments memo

$25–50K

M&A Buy-Side Diligence Support

Add-on acquisitions, model validation, integration framework

$30–60K

Exit Readiness Sprint

12 weeks · Transaction-grade financials, equity story, data room

$50–75K

Track Record

NASDAQ: OPRX

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.

$95M

Sale to OptimizeRx, October 2023

3×

Revenue scaling: $15M to $40M

20%+

EBITDA margin, from break-even

500%

Cash flow position improvement

— Selected results from earlier roles

$30M

Profitability lift

Subsidiary of NYSE: CNA

CNA National Warranty

AVP · Financial Planning & Analysis

Led data-driven pricing strategy and product-level P&L redesign across the warranty book. Identified and executed $30M in profitability improvement through analytical pricing, segmentation discipline, and underwriting model refinement.

$20M

Annual operating savings

NYSE: HIG

The Hartford

Senior Consultant · Strategic Finance

Architected organizational redesign and operating model optimization across business units. Delivered $20M in annual operating savings through restructuring, span-of-control rationalization, and process redesign.

+50%

Book transfer premiums

NYSE: THG

The Hanover Insurance Group

Regional Financial Officer

Built profile-based acquisition strategy targeting commercial lines book transfers. Delivered a 50% increase in transferred premium volume year-over-year through analytical targeting and a producer engagement model.

In Their Words

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.

Michael Weintraub

Founder & CEO, Medicx Health

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.

James McHugh

Principal, CliftonLarsonAllen (CLA)

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.

Wes Smith

Actuary & Health Benefits Consultant

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.

Mark Lange

Division President, Arch Insurance Group

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.

Glenn Shapiro

Former President, Personal Lines, Allstate

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.

Gary Stephen

Former EVP, Claims & Risk Mgmt., PURE Insurance

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.

Michael Binns

President, Patriot General Agency

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 McAlindin

Former SVP Claims, MAPFRE

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.

Dina MacEwan

Assistant Director, OptimizeRx

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.

Michael Panken

Senior Sales Executive, Travelers Insurance

How I Work

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.

— 01

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.

— 02

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.

— 03

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.

— 04

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.

Scott Magnano, CFO and Founder of Magnano Advisory

Scott Magnano
Founder & CFO

About

"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.

Scott Magnano

Founder & CFO, Magnano Advisory

Insights

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.

Sell-Side & Exit

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 →

FP&A

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 →

AI & Finance

Where AI Belongs in the CFO Stack (and Where It Doesn't)

Three places AI belongs in the CFO stack. Three places it doesn't. A skeptic's view from the operator who used it through diligence on a $95M sale.

Read →

View all Insights →

Common Questions

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? +

A fractional CFO, or CFO advisor, gives you senior strategic finance leadership at one-third to one-half the cost of a full-time hire, with no equity dilution, no search timeline, and no severance exposure. The right model for companies that need CFO-grade thinking but don't yet need... or can't yet justify... a full-time seat.

What's the difference between your retainer tiers? +

Foundations is for strategic finance visibility and a senior CFO sounding board. Growth adds operating cadence and board-grade reporting. Board-Ready adds transaction prep and capital-event leadership. Acting CFO is a near-full-time interim engagement for turnaround or transaction-heavy situations. Tiers are designed to flex up or down as needs change.

What does a CFO advisory engagement cost? +

Retainers start at $3,000 per month for a light advisory relationship and scale to $25,000+ for a near-full-time acting CFO role, depending on cadence and scope. A one-time mobilization fee applies at the start, and project work is scoped individually. The lowest-commitment way to begin is the Strategic Finance Pulse Check... a fixed $5,000 for a 30-day diagnostic.

Why a 90-day initial term? +

Real strategic finance work doesn't show return in 30 days. The 90-day term protects both sides... you get committed senior attention and continuity, and I get the runway to deliver something measurable. After the initial term, engagements are month-to-month.

How do you structure and price engagements? +

Engagements are built as flat-fee retainers or scoped projects, so the focus stays on outcomes and your costs are predictable from day one. Retainers run on a monthly cadence; projects come with defined deliverables and timelines. If your situation doesn't fit a standard tier, I'll build a custom retainer scoped to where you actually are.

What if I'm not sure which tier is right? +

Start with a Strategic Finance Pulse Check ($5K, 30 days). You get a 5–10 page Findings Memo on Cash, Margin, and KPI maturity, plus a prioritized action list and a retainer recommendation. 100% of the fee credits against the mobilization fee on any retainer signed within 60 days of memo delivery. Standalone engagement... no MSA required.

Can I skip the Pulse Check and go straight to a retainer? +

Yes. The Pulse Check is an optional on-ramp for situations where scope isn't yet clear. If you already know which tier fits and your priorities are defined, we go straight to MSA, SOW, and Kickoff. Mobilization fee applies normally. Typical timeline: signed paperwork to engagement start in two to three weeks.

Do you only work with healthcare and PBM companies? +

Healthcare and PBM is where I have the deepest operating experience and where pattern-matching is fastest. But the foundational CFO work... cash, margin, capital strategy, transaction readiness... translates across industries. PE-backed services, insurance, and tech-enabled companies are also a strong fit.

How do you handle confidentiality and conflicts of interest? +

Every engagement starts with a mutual NDA and a master services agreement covering confidentiality, HIPAA where relevant, and professional liability coverage. I work with a deliberately small number of clients, so conflicts are rare. If one ever surfaces, I disclose it to both parties before touching anything related to it. Your financials and deal information stay protected, full stop.

What's the mobilization fee for? +

One-time setup work: kickoff diagnostic, systems and reporting assessment, team integration, and a 30-day priority plan. It's separate from the monthly retainer because the work is front-loaded and doesn't repeat. Scoped at the SOW level.

What happens when the engagement ends? +

Part of the job is making myself replaceable. When a company is ready for a full-time CFO, I help define the role, screen candidates, and transition the function so nothing breaks in the handoff. Many engagements are built toward exactly that moment.

How quickly can you start? +

Typically two to three weeks from signed SOW. Acting CFO engagements can move faster when situation severity warrants.

Built to Stabilize. Scale. Exit.

One foundation. Three horizons.

The First 90 Days

The Next 24 Months

The Next 36 Months

A narrow focus. The right kind of work.

Funded & Founder-Led

Hyper-Growth & Scale-Stage

Turnaround & Exit-Ready

The right first step. When scope isn't yet clear.

How the 30 days work.

Three retainer tiers. One menu of project work.

Medicx Health: from three months of cash to a $95M exit.

Vouched for by CEOs, presidents, and operators.

Strategic and operational. Built around the data.

Diagnose Before Prescribing

Frame as the Operator

Leverage AI and Data

Build for the Buyer

Notes from the CFO seat.

What Bankers Want in a Seller's CFO

The $40M Ceiling: Where Founder-Built Finance Stacks Break

Where AI Belongs in the CFO Stack (and Where It Doesn't)

Answers before the call.

Let's talk about what's next.

Book a 30-minute diagnostic call.