Meet Rich Melke

HOPE's Number Cruncher In Chief

By Liz Ferrell, Development and Community Relations Specialist

HOPE CFO Rich Melke makes a pretty convincing Forrest Gump.

On his first day as a HOPE employee, Chief Financial Officer Richard Melke came to work dressed as Forrest Gump.

 To be fair, it was the week of Halloween. HOPE staff dresses in costume every day during the week leading into Halloween. And there was Rich, a true team player,  dressed as Forrest Gump in his plaid shirt and bowtie, neatly pressed khakis and running shoes, walking around with a box of chocolates in his hand, proclaiming, “Life is like a box of chocolates. You never know what you’re gonna get!”

“I wanted to hit the ground running,” he explained later.

Rich may share Forrest Gump’s modesty and unassuming manner, but behind his calm demeanor is a dedicated, disciplined leader and a willing teacher and mentor for HOPE’s financial team. In his nearly four years as CFO, Rich’s steady hand and quiet competence have helped HOPE navigate numerous difficulties and set the organization on a course of financial stability.  

“Do Tomorrow’s Work Today”

“The CFO has three areas of responsibility,” Rich once told the Board, “Billing and revenue cycle, accounting, and finance.” For the first two items Rich works with HOPE’s finance team, which consists of a staff accountant, two accounting support specialists, a revenue cycle manager, a billing and eligibility specialist, and a front office coordinator. But the daunting tasks of forecasting financial trends, analyzing and anticipating their potential impact on HOPE’s operations and bottom line, and creating budgets that build reserves in preparation for economic fluctuations – all these fall squarely on Rich’s shoulders.

Such responsibility can be unnerving in the best of times, but Rich takes every situation in

stride. At HOPE, as with any organization, last-minute challenges arise that require quick adjustments – changes as positive as revising the budget to accommodate incoming grant funds, or as negative as losing revenue when a provider leaves. But Rich and his finance team operate by the motto “Do tomorrow’s work today,” and that enables them to adapt quickly to unexpected contingencies.

Finally, Rich does not sugarcoat difficulties. He presents a situation, explaining possible options with their pros and cons, and provides HOPE’s leadership team with the information they need to chart a course forward. His approach has served HOPE well.

A Little About Rich

Richard Melke grew up in the Detroit area until age 12, when his family moved to Michigan’s northern lower peninsula. He graduated from Charlevoix High School, then earned an Associate of Arts in Commerce and Accounting from North Central Michigan College; a Bachelor of Arts in Business Administration from Ferris State University in Traverse City; and a Master of Business Administration from Lake Superior State University in 1989.

Rich's career path equipped him to be just the right CFO for HOPE Family Health.

He began his finance career working with accounting systems, as a financial analyst and as a business manager at hospitals in Michigan hospitals before going another direction.

“Healthcare was going through a change in the late 1990s,” Rich said. “I wanted to put my master’s degree to work, so in 2000 I accepted a job at a small private prison, the Michigan Youth Correctional Facility, as Business Manager and Assistant Warden.”

In 2004 Rich began the career track that would eventually lead him to HOPE, serving over two years as CFO for an FQHC with three Michigan locations before going to work for GEO Care, which provided forensic psychiatry for residents of a prison facility in Miami, Florida.

“That’s where I learned more about behavioral health and the serious mentally ill,” Rich said, “interacting with staff and with the incarcerated. I was on call every seventh weekend.”

The 2008 economic downturn led to the corporation losing some contracts, so Rich returned to the world of FQHCs, where the Affordable Care Act had increased funding opportunities. During his 20 years of working almost exclusively at FQHCs, Rich’s understanding of FQHCs has expanded. He has served three stints as Chief Financial Officer, three as Chief Executive Officer, once as Chief Operations Officer, and once as Director of Finance, across Tennessee, Virginia, Delaware, Illinois and Michigan before making his way back to the South’s milder winters.

Finding HOPE

After three years serving as a Director of Finance, Rich realized he was doing CFO-level work and decided to pursue a CFO title and salary. A man of faith, he also felt a call to serve at a faith-based organization. When he saw HOPE’s job posting, he felt it would be compatible with his skill set. He and Nancy, his wife of 41 years and a former pharmacy technician who shares his passion for healthcare, prayed together about this opportunity. His previous work at ETSU had made him familiar with the Tennessee Primary Care Association, and he was familiar with the Sage and eClinical Works systems that HOPE uses for financial and patient records. He came to HOPE in October 2021.

Rich has accomplished much since joining the HOPE family, including leading HOPE to have zero findings for its 2024 financial audit by an independent third-party auditor. But his greatest legacy at HOPE may lie in the turnaround he helped bring about last year.

In 2024 HOPE experienced a budget shortfall. HOPE had established a site in Gallatin in December 2023. But even with increasing appointments and insurance credentialing, 2024 began with a loss that compounded monthly. Start-up costs exceeded projections; reimbursements were delayed; uninsured patients comprised half of Gallatin appointments. HOPE was forced to tap its reserve funds.

Initial steps to mitigate the shortfall proved ineffective, and by late summer HOPE’s leadership team decided to implement a “Hail Mary” strategy: postponing projects, cutting unnecessary expenses, freezing pay and seeking approval for a Medicaid Prospective Payment System (PPS) rate increase. They also reluctantly implemented a dreaded reduction in force, carefully identifying positions least likely to impact operations and staff morale while still achieving the financial results necessary for HOPE’s survival.

Cutting eight positions saved HOPE nearly $400,000, quickly improving cash flow. HOPE’s approved Medicaid PPS rate increase and reimbursements for Gallatin expansion came through, HOPE received two new grants, and staff morale rallied. Amazingly, HOPE ended 2024 with a surplus. The financials during 2025 have continued to improve each month, with cash on hand triple what it was this time last year.

Rich (left) organized a HOPE choir, "Echoes of HOPE," and is in charge of music selection and playing keyboard as well as singing in the group.

Today, Rich commutes to Westmoreland from Bowling Green, Kentucky, where he and Nancy reside. They travel frequently to Michigan to visit their daughters Amanda and Tiffany and their families; they’re particularly excited because in November Tiffany will make them first-time grandparents. Rich greatly enjoys all types of music, but especially worship music. He sings baritone, plays piano and organ, and occasionally leads the HOPE choir “Echoes of HOPE.” He works to stay healthy with exercise and, just like Forrest Gump, is a runner.

Run, Rich, run! HOPE is cheering you on!

#HOPEFamilyHealth #meetthestaff #healthcenter #CFO #finance #FQHC