Position Summary
The Vice President, Financial Operations for the Health System's Medical Group serves as the senior financial leader for all employed and faculty-affiliated clinical practices across ambulatory and hospital-based settings. The role provides strategic and operational financial leadership to support clinical growth, academic missions (education and research), high reliability operations, and performance aligned with the health system and Brody School of Medicine (SOM). The VP Finance is responsible for financial planning, physician compensation governance, revenue cycle optimization, practice economics, capital stewardship, and performance improvement, ensuring transparency and accountability across the Medical Group, Academic Medical Center (AMC), and SOM.
Responsibilities
Lead multi year financial planning, annual budgeting, and rolling forecasts for the Medical Group, aligned with system strategy, AMC service lines, and SOM priorities.

Leads regionalized business specialist embedded in medical group operations to support business planning and budgetary performance.

Leads and supports projects designed to improve the financial position of ECU Health Physicians.

Develop P&L visibility at enterprise, department, service line, division, and provider levels; own margin improvement and productivity targets.

Partner with strategy and population health leaders to evaluate new markets, practice acquisitions, and JV opportunities; lead pro formas, sensitivity analyses, and Board level business cases.

Steward capital allocation for clinics, digital health, and enabling technologies; manage portfolio ROI and post implementation reviews.

Leads consolidated academic and community practices financial processes for the purposes of enterprise level performance awareness and improvement.

Surfaces favorable and unfavorable financial and operational trends to generate financial sustainability.

Supports multiyear operational and capital planning with site and service rationalization analysis.

Monitors and supports key performance indicators regarding market-based growth objectives.
Drive clinic and provider productivity optimization (wRVU, panel size, template design, access metrics) while maintaining high quality and patient experience.

Partners with hospital based operational and financial leaders to ensure shared financial stewardship.

Establish standardized cost accounting and clinic operating models (staffing, throughput, room utilization, supply and non labor spend).

Lead monthly financial close, variance analysis, and operational performance reviews with practice leadership, department chairs, and service line leaders.
Co lead the institutional funds flow model between the Health System and SOM, aligning missions (clinical, education, research) with transparent methodologies for support and incentives.

Partner with AMC departmental finance leaders to clarify direct and indirect cost allocations, faculty FTE support, GME considerations, and research subsidy governance.
Align finance policies with compliance requirements unique to academics (effort reporting, grant cost share, restricted funds).
Partner with the ECU Health Vice President of Revenue Cycle to optimize medical group net patient revenue (Pre-AR, charge capture, denial prevention, A/R days, cash collections, net revenue integrity).

Collaborate with managed care on fee schedules and value based/risk contracts; model downside/ upside risk, RAF, quality incentives, and care management investments.

Partner and facilitate oversight and processes for documentation accuracy and CDI initiatives; guide coding education and audit programs (professional and facility where applicable).
Participate in the development of and changes to the physician and APP compensation frameworks (wRVU, quality incentives, panel/access, citizenship/academic metrics) aligned with fair market value (FMV) and commercial reasonableness.

Provide transparent compensation dashboards and true up processes; ensure contract compliance and equitable specialty specific structures.

Support recruitment/retention through offer modeling, ramp schedules, and relocation/start up economics.

Integrate quality, equity, and cost metrics into provider incentives and practice management.
Ensure compliance with federal/state regulations, billing and coding standards, Stark/AKS, FMV, 340B implications for clinic operations, and research related financial controls.

Maintain robust internal controls, revenue recognition policies, and audit readiness.
Lead, mentor, and develop a high performing finance operations team to support operational performance efficiency, partnering with shared service areas to drive continuous operating improvement.

Foster a culture of partnership with clinical and academic leaders; translate complex financial concepts into actionable operational plans.

Model the organization's values, with a commitment to health equity and community impact.

Minimum Requirements
Required:
Bachelor's degree in Accounting, Finance, Business, or related field.

10+ years progressive healthcare finance leadership, including direct experience with multi specialty medical groups and academic health systems.

Demonstrated success in physician compensation governance, professional revenue cycle, and practice economics.

Expertise with EHR/PM systems (e.g., Epic Resolute Professional/Clarity), cost accounting/decision support, and advanced Excel/BI tools.

Strong understanding of value based/risk models, managed care, and regulatory frameworks (Stark, AKS, CMS, OIG).

Preferred:
Master's degree (MBA, MHA, MPA) or CPA/CHFP/FHFMA.

Experience leading funds flow models with SOM/AMC stakeholders.

Prior leadership over centralized medical group finance and shared services.

Familiarity with research finance, GME, and 340B operational intersections.

Core Competencies:
Strategic Agility & Systems Thinking across clinical, academic, and financial domains.

Influence & Partnership with physician leaders and academic stakeholders.

Analytical Rigor with ability to translate data into action.

Operational Excellence and continuous improvement mindset (Lean/Six Sigma a plus).

Change Leadership and talent development.