Built to Stabilize. Scale. Exit.
Fractional CFO services for founder-led and PE-backed companies. I make the economics of a growing business visible... which products, customers, and contracts are building enterprise value and which are quietly consuming it... and then take the seat to fix it. 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.
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. Most arrive having already said one of three sentences out loud. This work starts to pay for itself past the point where a controller and a spreadsheet can carry the decisions... a company with real revenue, real complexity, and a board, lender, or buyer asking questions the current reporting cannot answer.
“Revenue is growing, but I don't trust the economics.”
Pricing evolved opportunistically, products multiplied, and no two customers or contracts earn the same money. The work is making the economics visible... product-level P&Ls, customer and contract profitability, pricing discipline... so leadership can tell which growth is building enterprise value and which is quietly consuming it. Ten free questions will tell you which way yours is running.
“Our financial infrastructure hasn't grown up with us.”
The company reached real scale while still running on reporting, forecasting, and decision habits built for a much smaller business. Intuition stopped scaling. The work is FP&A that matures alongside the company... credible forecasts, KPI architecture, board-grade reporting, and systems that hold up under a lender, investor, or buyer.
“We need to increase enterprise value before a capital event.”
A sale, recapitalization, or raise is on the table, and a company is not transaction-ready simply because someone wants to transact. Whether the first 90 days are about stabilizing cash, margin, or covenant pressure, or the next 36 are about exit prep, the work runs on the same foundation... EBITDA quality, margin durability, clean data, and a financial story that holds up when a buyer's diligence team rebuilds it.
- EBITDA lags despite top-line growth
- Pricing and discounting lack discipline
- Cash pressure is building under growth
- Forecasts no longer feel reliable to leadership or investors
- Board reporting has become reactive, not strategic
- The CEO has become the de facto finance function
- Diligence, a capital raise, or an exit is on the horizon
- Covenant or lender pressure is building
- The numbers would not survive a buyer's diligence team
- EBITDA ExpansionMargin discipline through pricing, mix, and operating leverage
- Pricing & Unit EconomicsSegmentation, price realization, and discount control
- Product-Level P&LFully loaded margin by product and service line
- Customer & Contract ProfitabilityWhich accounts earn their keep, and which do not
- Forecasting & KPI InfrastructureDriver-based models leadership and investors can trust
- Cash Flow Visibility13-week and long-range cash, with covenant and runway management
- Board & Investor ReportingStrategic packages that move conversations forward
- Finance Team ScalingFrom founder-built to institutional-grade finance org
- Strategic PlanningMulti-year operating plans tied to capital strategy
- Transaction ReadinessDiligence prep, banker management, equity story
- EBITDA QualityAdd-backs and a bridge that survive a QofE rebuild
- Data Room & DocumentationThe evidence set a buyer asks for, ready in advance
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.
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.
The $95M was the outcome, not the achievement. What a buyer paid for was durable margin, a recurring revenue engine, clean numbers, and a growth story that survived diligence... all of it built in the four years before anyone called a banker.
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.
Start with a read. Not a retainer.
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 on where your growth creates enterprise value and where it consumes it, how much cash you actually have, and whether the systems, the close, and the ownership underneath the numbers have kept pace with the company. It ends in a prioritized action memo, and that memo decides the next step. If a retainer follows within 60 days, the fee credits against mobilization.
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 your economics, cash position, and the systems and ownership underneath the numbers. 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.
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. Unit economics, cash, the systems and ownership underneath the numbers, and the gap 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, scaling, 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.
The Board Reporting Pack PE Sponsors Actually Read
Sponsors now weigh four priorities almost equally. The one page that answers all four, the five numbers on it, and what it costs you when they are missing.
Read →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 →Answers before the call.
Questions about fees, tiers, and how engagements are structured are answered in full on retainers and pricing.
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?
Why a 90-day initial term?
Do you only work with healthcare and PBM companies?
How do you handle confidentiality and conflicts of interest?
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.