In our work advising boards and CEOs on CFO leadership across growth sectors, we’ve noticed a consistent pattern.
The CFO role isn’t simply expanding, it’s splitting.
And the implications for hiring, succession, and performance are consequential.
A Co-Authored Piece by:
Antonia Halliday, Partner, Finance Leadership Practice Leader
Christos Richards, Partner, Global Head of Healthcare & Life Sciences
David Schumer, Managing Partner & Head of Financial Services Practice
The Chief Financial Officer role used to be about control. Built on accounting rigour and financial stewardship, it evolved alongside globalisation and increasing business complexity. Today, as healthcare and particularly biotech have become increasingly dependent on continuous external capital, and as advanced technology and FinTech face intensified market scrutiny, finance leadership is no longer just changing. It’s being rewritten.
For a long time, the CFO path was familiar. You ran the numbers, kept the business honest, and gradually grew into a strategic partner. Expectations were clear, and the role itself was relatively stable. That version of finance leadership is disappearing.
Since the post–Sarbanes-Oxley era, we’ve watched the CFO role quietly split into two very different shapes. Not because finance leaders changed, but because the demands placed on them became more specific, more visible, and far less forgiving.
At a high level, two CFO archetypes have emerged as the norm across high-growth sectors. Most finance leaders carry elements of both, but increasingly one side dominates depending on industry context. One CFO lives inside the business. The other lives at the edge of the market. That distinction matters more now than ever.
The first archetype is what many think of as the operator-CFO. This is the finance leader obsessed with how decisions actually land. Forecasts aren’t theoretical. Systems matter. Margins, process, and execution are where credibility is built. Their influence comes from being indispensable to how the company runs day to day.
The second is the capital-markets CFO. Outward facing by instinct, often with foundations in investment banking or strategic finance, they’re comfortable in rooms with investors, regulators, and bankers. Their credibility is built externally. Their training creates an instinctive understanding of volatility, narrative control, and capital timing, especially when markets are uncertain and optionality matters.
For decades, companies assumed the right CFO could do both equally well. In practice, industry reality is now forcing a choice. Nowhere is that choice clearer than in healthcare when viewed through a biotech lens.
Historically, healthcare finance leadership was shaped by constraint. Margins were thin. Payers mediated revenue. Regulation was constant. Labour costs were volatile. In that environment, precision and operational fluency mattered more than market storytelling. Healthcare organisations rarely failed because they couldn’t tell a compelling story. They failed because the economics were hard and the risk was real.
That reality explains why healthcare companies long favoured the operator-CFO, leaders deeply fluent in reimbursement mechanics, service line economics, and regulatory impact. When they spoke to boards, they reduced anxiety by bringing clarity and control.
Biotech has changed that equation.
Biotech doesn’t just operate under constraint; it operates under continuous capital dependence. The pace, scale, and sequencing of external financing are existential. Runway is strategy. Market perception matters. Banking relationships matter. Timing matters.
In this environment, operational excellence is necessary, but no longer sufficient.
Biotech CFOs must be able to translate science into investable narratives, manage capital markets expectations across cycles, and maintain credibility with investors long before revenue exists. They need fluency in financing structures, dilution trade-offs, and market psychology, not as a secondary skill, but as a core competency.
Capital markets experience is no longer just ‘helpful’ in biotech. It has become foundational.
As a result, the biotech CFO archetype is evolving. The anchor still matters, with discipline, rigour, and realism remaining critical. But biotech increasingly demands a CFO who can stand confidently at the edge of the market while keeping the organisation steady inside it. That tension now defines the role.
Advanced technology sits in a different, but equally challenging place.
For much of the last decade, growth was the dominant currency. Capital was abundant. Inefficiency was tolerated. Systems often lagged behind scale. As long as the narrative was compelling, the market was forgiving.
But that environment has shifted and today’s advanced technology CFO is being asked to restore credibility without extinguishing ambition. The role now sits at the intersection of discipline and belief, between what the business can deliver operationally and what the market is still willing to underwrite.
Here, the CFO archetypes collide.
Advanced technology still values the capital-markets CFO, and leaders who can manage investor expectations, shape valuation narratives, and time capital decisions thoughtfully. But storytelling that outpaces operational reality is quickly exposed. Markets are less patient, and confidence must now be earned.
At the same time, the operator-CFO has moved to the foreground. Forecast accuracy matters again. GTM efficiency is scrutinised. Alignment between headcount, product roadmaps, and revenue can no longer be loose. Systems that once felt ‘good enough’ now undermine credibility if they don’t scale.
The modern advanced technology CFO must bridge these two worlds. They translate operational truth into a narrative the market can trust and ensure capital strategy is grounded in execution, not aspiration. In advanced technology, credibility is no longer borrowed from growth. It has to be rebuilt.
FinTech pushes the CFO role in yet another direction.
In FinTech, credibility isn’t abstract. It’s existential. Regulators are watching. Banking partners are cautious. Investors are acutely sensitive to risk, liquidity, and governance. Market confidence can shift quickly, and when it does, the consequences are immediate.
This reality pulls the CFO role strongly toward being highly strategic. FinTech CFOs are expected to project institutional maturity early. They must be credible with regulators, fluent in capital and liquidity requirements, and disciplined in how they communicate risk to key internal stakeholders and board members, as well as externally to prospective and existing clients.
FinTech also moves fast. Transaction volumes shift rapidly. Fraud risk evolves constantly. Unit economics can change overnight. A CFO who operates only at the edge of the market will struggle without deep visibility into the business itself.
The most effective FinTech CFOs pair external fluency with real operational awareness. They understand the mechanics of the platform well enough to respond in real time, not just explain results after the fact. Boards often see them as guardians of trust, responsible not only for financial performance, but for the company’s legitimacy.
Across biotech, advanced technology, and FinTech, the CFO role is not converging toward a single ideal profile. It is fragmenting, becoming more specialised, more contextual, and more demanding.
What works in one sector fails in another. And even within sectors, the right CFO profile depends on where the company is in its lifecycle, and which risks dominate the next chapter.
The organisations that get this right are the ones that stop hiring against generic CFO templates and start hiring against reality. They are explicit about which version of the CFO role they need, and they align expectations accordingly.
The future of finance leadership isn’t about doing everything equally well. It’s about knowing which version of the job matters most and leading from there.