Fractional CFO  ·  Built for Scale & Exit

Built to Scale.
Built to Exit.

Strategic, fractional, and project-based CFO leadership for founder-led and growth-stage companies navigating scale, profitability, operational complexity, and exit readiness. The same playbook that took Medicx Health from $15M to a $95M exit.

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Career At-A-Glance
$95M
Sale of Medicx Health to OptimizeRx (NASDAQ: OPRX), October 2023
3×
Revenue scaling: $15M to $40M, with 20%+ EBITDA margins
25+
Years of CFO and senior finance leadership across growth and complex businesses
Exit Readiness Capital Strategy Financial Transformation M&A Diligence FP&A Build-Out Pricing & Unit Economics AI & Data Leverage Board & Investor Relations Exit Readiness Capital Strategy Financial Transformation M&A Diligence FP&A Build-Out Pricing & Unit Economics AI & Data Leverage Board & Investor Relations
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: scaling toward a meaningful capital event or exit.

— 01

Startup & 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

Series B through pre-exit 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.

Series B+ $15–100M Revenue Operating Maturity
— 03

Exit-Focused & PE-Backed

Companies positioning for transaction in 24 to 60 months, in active turnaround, or under PE ownership. EBITDA expansion, transaction prep, and the kind of financial story that holds up to PE and strategic diligence.

Exit Prep PE-Backed Turnaround
Industry Expertise
Deep operator experience across healthcare, technology, insurance, services, and PBM. Comfortable with both regulated and unregulated complexity, payor and provider economics, subscription and transactional revenue models, and the data infrastructure required for each.
Services & Engagement

Three retainer tiers. One menu of project work.

Engagements are flat-fee, scoped, and outcome-driven. Hourly billing creates clock-watching in conversations that should be strategic. Retainers come with monthly cadence; projects come with defined deliverables and timelines.

Foundations
Bi-weekly executive partnership + lightweight finance build
$5,000/mo
Starting investment · Setup 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
Weekly engagement + embedded operating partnership
$10,000/mo
Starting investment · Setup 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
Multi-touch weekly + full CFO oversight
$15,000/mo
Starting investment · Setup fee separate · Controller required *
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
* Board-Ready assumes an internal controller (or comparable) handling execution-layer finance work. Without an internal controller, engagement scopes at 1.5x ($22,500/mo) to cover the additional execution responsibility.

Need more? Custom Acting CFO engagements available for pre-transaction companies requiring near-full-time CFO presence... scoped and priced case by case.
Project Engagements
Defined scope. Defined deliverables.
Project engagements pair well with retainers or stand alone. Pricing reflects typical scope; final fee is set after a no-cost discovery call.
— 01
Capital Events & Transactions
Transaction-grade preparation, diligence, and execution support for liquidity events.
Exit Readiness Sprint
12 weeks • Transaction-grade financials, equity story, data room
$50–75K
Capital Raise Support
Modeling, deck, lender or investor narrative
$25–50K
M&A Buy-Side Diligence Support
Add-on acquisitions, model validation, integration framework
$30–60K
Quality of Earnings Preparation
Sell-side QoE prep, pre-diligence cleanup, adjustments memo
$25–50K
— 02
Build & Operate
The financial infrastructure required for scale, board reporting, and operational discipline.
Financial Model Build or Refresh
Driver-based, scenario-ready, board-grade
$15–30K
13-Week Cash Flow Model
Rolling weekly forecast with refresh protocol
$7,500
Annual Budget Build
Driver-based budget, monthly phasing, departmental P&Ls
$12–18K
KPI & Reporting Dashboard Build
KPI architecture and dynamic dashboard in client tools
$10–15K
Board Reporting Package Setup
Deck design, KPI architecture, narrative, first-quarter package
$12–20K
— 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
Diagnostic & Systems
Structured assessments and systems oversight to identify gaps and modernize finance infrastructure.
Financial Transformation Assessment
30-day diagnostic • Cash, P&L, KPIs, 90-day action plan
from $12.5K
ERP Selection & Implementation Oversight
NetSuite, Sage Intacct, or comparable
$20–40K
Track Record
NASDAQ: OPRX

Medicx Health: from break-even to a $95M exit.

Joined Medicx Health as CFO in 2019 facing three consecutive years of declining revenue and three months of cash on hand. Led a complete financial and operational transformation: rebuilt the operating model, redesigned product-level P&L and pricing, eliminated company debt, and modernized the financial infrastructure with NetSuite.

Took the company from declining to record-setting revenue, with EBITDA expanding from break-even to over 20% margins. Led the company through a successful sale to OptimizeRx 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 improvement at CNA National Warranty via data-driven pricing strategy
$20M
Annual operating savings at The Hartford through organizational redesign
+50%
Increase in book transfer premiums at The Hanover through profile-based acquisition strategy
In Their Words

Vouched for by CEOs, presidents, and operators.

Selected from a network of CEOs, C-suite executives, and senior operators across healthcare, insurance, technology, and services. Sourced from LinkedIn recommendations.

"

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 fractional finance done right is half thought partnership and half hands-on execution. I lean on data, AI tooling, and a CFO operator's instincts to make the financial picture clear, then move 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

Modern CFO work demands modern tooling. I bring AI-augmented modeling, scenario analysis, and reporting workflows that compress what used to take weeks.

— 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 a struggling growth-stage business to a $95M sale to OptimizeRx in 2023.

Through Magnano Advisory, I partner with a select group of startup, hyper-growth, and exit-stage companies across healthcare, technology, insurance, services, and PBM. The work spans full fractional 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.

I'm based in the Phoenix area, work nationally, and partner with founders, CEOs, boards, and PE operating partners across the country.

Scott Magnano
CFO & Founder, 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.

Exit Strategy

The Three Things Buyers Actually Diligence Before Closing

Customer concentration, contract durability, and the gap between management EBITDA and QofE-grade EBITDA. Where most sellers find out about the haircut in week 6 of diligence... too late.

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 →
Start a Conversation

Let's talk about what's next.

Ready to talk?

Book a 30-minute discovery call.

Pick a time that works. No prep needed. We'll talk about where the business is and where it's going.

Book a Discovery Call →

Prefer to write first? Use the form on the right. The first conversation is a no-cost 30-minute discovery 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.

Email
scott@magnanoadvisory.com
Phone
480.818.5066
LinkedIn
linkedin.com/in/magnanos
Location
Greater Phoenix · Working Nationally

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