Director Physician Revenue & Operations

SUMMARY:

The Director of Professional Receivables will report to the Vice President of Finance. This role owns physician revenue performance across the pre-bill, mid-cycle, risk revenue, and reimbursement domains, while the Central Billing Office (CBO) retains operational responsibility for professional billing, A/R follow-up, cash posting, and collections. The Director serves as the accountable PO leader for revenue outcomes, workflow design, issue escalation, and physician practice readiness, partnering closely with CBO leadership to drive optimal end-to-end results.

The director serves as the principal operational liaison to CBO leadership, supports the centralization of physician-office billing, is accountable for oversight of risk revenue physician programming along with medical director, and provider credentialing oversight. This position plays a critical role in advancing system integration efforts and safeguarding financial performance for all PO practices.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these guide our everyday actions with patients, customers and one another.

Serve as the accountable PO operational leader and primary liaison between the Physician Organization and the Central Billing Office (CBO), ensuring physician practices are optimized for centralized billing success.

Partner with denials and appeals teams to reduce revenue leakage by identifying root causes of payer denials and strengthening frontend and midcycle workflows that impact reimbursement.

Evaluate A/R balances and trends to identify upstream operational, documentation, or authorization drivers, escalating systemic issues to CBO leadership and driving PO-level corrective action.

Review charge reconciliation processes across PO practices to ensure timely, complete, and accurate charge submission.

Collaborate with revenue integrity by ensuring accurate documentation, coding, billing, and reimbursement practices in partnership with compliance and clinical leaders.

Lead PO revenue integrity efforts in partnership with compliance, coding, and clinical leaders, ensuring physician documentation and coding practices support accurate billing and optimal reimbursement.

Partner with the Director of Registration on front-end centralization initiatives, standardizing workflows for registration, eligibility, financial clearance, and pre-authorization.

Oversee PO provider credentialing processes and payer enrollment to prevent revenue delays.

Oversee processes that ensure timely and accurate assignment of HCC and other risk based codes, incorporating best practices for condition validation, recapture, and annual review.

Collaborate with analytics, finance, and population health teams to understand risk score performance and identify opportunities to strengthen documentation completeness and coding accuracy.

Monitor reimbursement performance across all major commercial, Medicare, and Medicaid payers to identify trends, payment variances, and opportunities to improve overall reimbursement rates for physician services.

Partner with payers and internal reimbursement teams to resolve systemic payment issues, including underpayments, rate discrepancies, and contractual misalignments.

Lead analyses of reimbursement patterns by payer, specialty, and service line to understand financial impacts and support strategic decision-making for the Physician Organization.

Physician practice alignment with centralized billing standards.

Monitor KPIs and revenue trends; identify performance gaps and implement corrective actions to improve outcomes.

Performs other duties as assigned.

EDUCATION:

Bachelor's degree in Healthcare Administration, Business, Finance, or related field required.

EXPERIENCE:

7-10 years of progressive experience in physician revenue cycle leadership within a medical group, academic health system, or larger multispecialty practice.

Experience managing centralized or multi-site revenue cycle operations strongly preferred.

Demonstrated success improving revenue performance and operational efficiency in physician practice environments.

Comperehensive understanding of physician revenue cycle operations including charge capture, documentation, coding, denials, and A/R management.

Knowledge of CMS and commercial payer billing guidelines, regulatory compliance standards, and audit requirements.

Familiarity with HER and practice management systems; Epic experience preferred.

Leadership skills with the ability to influence, collaborate, and drive alignment across clinical and administrative stakeholders.

Analytical skills to assess revenue trends, identify breakdowns, and guide data-driven decision-making.

Strong communication and presentation abilities to convey complex issues clearly and effectively.

Problem-solving expertise with the ability to design and implement sustainable operational improvements.

Ability to manage multiple priorities and lead cross-functional projects supporting system-wide standardization efforts.

SUPERVISORY RESPONSIBILITY:

Management responsibilities up to 25 FTEs.

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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Driving Required: