Cascade County has hired the former CEO of Alluvion Health as its chief financial officer, a position that replaces the former budget officer role. Trista Besich started on June 3.
“I am excited to be back at the county,” Besich said. “I’ve got about 12 years of finance background, so it’s nice to be back, and I’m excited to be working with a bunch of people that I enjoy.”
Besich has been on county payroll before, but her most recent job was as CEO of Alluvion Health, the federally qualified health center based in Great Falls. She left Alluvion in March after a year of financial struggles for the clinic system.
Cascade County officials restored the CFO position to the finance department after former budget officer Mary Embleton retired. The county advertised for the position last year and held interviews this spring that were closed to the public. The advertised pay range was $115,000 to $130,000 annually. Besich was hired at a salary of $122,500.
After a final interview in closed session on May 13, County Commissioner Jim Larson announced that the county would extend an offer. He didn’t publicly name the chosen candidate.
It’s not unusual for staff position candidates to interview in closed sessions. In April, commissioners finished a round of similar closed sessions to select the Disaster and Emergency Services manager, Joey Zahara.
Other staff hires have been made in public settings. Earlier this year, county officials set public interviews for the high-profile elections administrator job after Clerk and Recorder Sandra Merchant was stripped of those duties.
Nearly a decade ago, Besich was CFO and chief operating officer of Community Health Care Center, a branch of county government at the time. She ultimately became CEO of that health clinic in 2018 shortly before it broke away from the county to form Alluvion, an independent nonprofit clinic system.
In the past year, Alluvion’s financial struggles led to staff furloughs, the closing of a lab subsidiary and most notably a pause on the massive construction project at the Rocky Mountain Building in downtown Great Falls. Alluvion faces $4.4 million in construction liens from contractors linked to the Rocky Mountain Building project, according to documents filed with the county.
Besich said that her job as Cascade County CFO will focus on budgeting, forecasting and accounting, among other duties. She intends to work on some grant support as well.
The budget process for the 2025 fiscal year is underway, and a preliminary operating budget is expected to be adopted later this month.

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