‘A family atmosphere’: Rob McVay reflects on 40 years with NRHA

In 1984, Rob McVay was a college student looking for part-time work when a friend’s helpful suggestion set his future in motion. At the time, NRHA was a young organization trying to find its footing, having recently expanded operations and moved to a new office in Kansas City, Mo. The nonprofit had a core group of dedicated staff members and lofty ambitions – and according to McVay’s friend, they needed a little extra help getting caught up on accounting, which McVay was studying at the University of Missouri-Kansas City.

Two years later, with his newly minted accounting degree in hand, McVay eagerly accepted a full-time role – and 40 years later, he is NRHA’s chief financial officer, providing guidance and leadership during a time of unprecedented rural health challenges and organizational growth. To celebrate his professional milestone, McVay looks back on his career, including how the organization has grown, how rural health has changed, and what makes NRHA special as we approach the association's 50th anniversary in 2027.

What do you remember most about your early days with NRHA?

In the early days, I remember it was a lot of fun. We were friends as well as coworkers – it was a different type of office culture in the 1980s – a very relaxed atmosphere. As time went on and NRHA continued to grow, we started to develop more as a professional organization – and this was around the same time I graduated from college, so I was ready to start my career.

Thanks to the work of NRHA’s leaders, the organization has always presented itself well even when things were challenging behind the scenes. For many years we struggled to find enough resources and have enough staff and expertise to fully develop as an organization. When we secured additional funding to get more resources, we started to hire more staff, and we started to grow – and this growth has been one of the organization’s most notable achievements, especially in recent years.

How has your role at NRHA changed over the years?

As chief financial officer, my role primarily focuses on accounting, finance, and the regulatory environment, but like a lot of CFOs I also see myself as a chief risk officer – I want to make sure we follow all the rules and can continue to grow sustainably.

Over the years we have built a great foundation and are a strong organization, which is exciting after operating for years with limited resources. Now when an opportunity for growth comes along, we can take full advantage of it. For example, this year for Annual Conference, we chose a larger venue in San Diego because we are betting on our growth. We wanted more people, more partners – we wanted it to be a destination for people. We can create a lot of excitement that way.

What has been most rewarding about your career with NRHA?

NRHA is a family atmosphere, especially for those who have been here a while – and with family you stick together to deal with good times and bad times. It’s rewarding because every day you’re helping people who you’ll never meet.

Working with the leadership in the organization has also been rewarding – I have admired them, and they have become my mentors. I used to be very involved in working with the board – I staffed four to five committees, and I got to work with a lot of volunteer member leaders who weren’t getting paid – they were just here because they cared about rural health and wanted to support this cause. I met some really amazing people and made friendships I still have today. In my personal life and community I also embraced the idea of volunteerism, which is a big benefit of working in the nonprofit sector.

What does the future hold for NRHA – and for you?

In this last stretch of my career, I want to continue to shore up NRHA’s foundation and ability to operate well from an administrative and finance perspective. I’ve been working to make sure our systems and procedures are well documented and that we are doing our job well from a regulatory perspective. I’ve been spending a lot of time on grants compliance management. I want to become more transparent with all of our planning and financial reporting, because I feel like that strengthens the organization. In the future, there will be need for additional support in NRHA, and I want to make sure there’s a solid foundation as we grow.

What makes NRHA a meaningful place to work?

At NRHA the people who stay – they stay a long time, which is rare in many jobs today. It’s because NRHA is a great organization. The freedom and flexibility of this job have been personally and professionally beneficial. After a certain amount of time, I’ve been able to create my own position. I’ve been able to define my role. You make this job what you want it to be. You can use this as an opportunity to grow professionally, which makes it a great place to work.

When people can embrace what we do, they find the work meaningful and rewarding – and I think a lot of long-time employees feel this way. I feel like my career has been very purposeful. Day to day, it can be easy to lose sight of the bigger picture – when you get up and go to the office every day and focus on completing your tasks, you can get lost in the details and lose sight of your purpose. But coming up on a momentous anniversary, I see it from a broader perspective. It feels good to have spent 40 years of my career helping other people.