Healthcare Finance Executive

Robert Firlit

CFO, Clinical Services  ·  U.S. Specialists Management

Architect of the finance function — connecting operations and physicians — for multi-specialty/market physician practice management.

Colleyville, TX  ·  nearly $1B revenue under management  ·  ~13 multispecialty markets
Robert Firlit
About

Finance leadership at the intersection of operations and technology

I’m a healthcare finance executive who has spent my career providing financial decision support to independent and physician-led organizations — building and leading the finance function across multi-entity, multi-specialty MSOs — including urology, oncology, neurosurgery, ENT, and more. Today I’m CFO of Clinical Services at U.S. Specialists Management, overseeing just shy of $1 billion in revenue under management across roughly thirteen multispecialty markets — urology, neurosurgery, orthopedics, otolaryngology, and oncology.

My edge is the intersection of finance, operations, and physician engagement. I own the economics that drive specialty-practice profitability — revenue cycle, ancillary services, specialty pharmacy, buy-and-bill, and rebate strategy. I build the technology that operationalizes them, enhancing productivity, while creating accessibility for providers and operators to gain greater visibility. I am the architect, developer, and facilitator. I stress-test automated functions/algorithms, with the unique knowledge of being the creator pre/post AI-driven output engines.

Before my move to USSM corporate, I was the market CFO embedded through a 5x revenue run ($30M → $150M) in St. Louis, MO. Prior to USSM, I have led finance and M&A work across genetics and urology platforms in Chicago and surrounding suburbs.

≈$1B
Revenue under management
~13
Multispecialty markets
5
Clinical specialties
5x
Market revenue growth led
Physician Practice Management PE-Backed Platform Finance Ancillary Services Economics Specialty Pharmacy Buy-and-Bill M&A & Financial Due Diligence Consolidated Reporting & FP&A Accounting Centralization & Org Design Revenue Cycle Management Payer & GPO Contracting Treasury & Debt-Covenant Compliance Forensic Accounting & Controls Cross-Market Standardization Finance Automation · Python / JS / AI Profits Interests & Equity
Flagship — what I built

The USSM Finance Hub

Ten markets. One ledger.

A cross-market finance automation platform I architected so every market — different software, different states — closes the books the same way. It harmonizes revenue recognition, clinical and pharmacy, onto one chart of accounts, one provider roster, and one drug-coding standard, and generates the journal entries that post to Sage Intacct.

Every market → one standardized ledger
01 · INGEST

Drag and drop exports

Ingests data from most practice-management systems, married with reference data that’s already built in.

02 · HARMONIZE

Map every line

Each row resolves to the same Sage dimensions — entity, department, class, employee — using one roster and one drug-coding standard.

03 · GENERATE

Entries ready to post

Balanced, dimensioned journal entries, packaged and ready to upload — in seconds.

The suite

JEnerator anchors a growing suite — several tools live today, others in testing and beta, and more on a dated roadmap. Every one is built on the same standards and the same data, so the picture stays consistent as it grows.

JEnerator

Live
Revenue · wRVUs · Statistics

Turns the monthly services report and dispense file into every journal entry the month needs — charges, cost of drugs, and adjustments — plus wRVU per provider and clinical statistics from the same upload.

Revenue Recognition

Live
Clinical revenue

The clinical-revenue engine: a full payer-contract-to-collections waterfall with denial and reserve modeling, and a standardized, physician-first trailing-twelve-month collection view across markets.

Market Reporting

Live
Weekly reporting · decks · cash

Keeps a market’s data current from weekly exports, then produces the recurring management, executive, and partner decks, the reporting workbook, cash-flow reconciliation, and month-end bank uploads.

DECKerator

Testing
Board deck builder

Drop the raw monthly feeds and get a finished board deck for any entity — with native, editable PowerPoint charts and tables.

Partner Compensation

Beta
Partner comp statements

Per-partner compensation statements — YTD detail, tax schedules, and year-over-year — each partner accessing their own securely.

Quarterly Distribution Model

Testing
Quarterly true-up

Models quarterly physician distributions — free cash flow through the working-capital reserve to per-partner checks, with a forward quarter that mirrors actuals.

K-1 Dashboard

In development
Physician distributions

Models member K-1 allocations against cash distributed — the hold-harmless test, estimated tax reserves, and a month-by-month ledger at any ownership percentage.

Group Performance Dashboard

In development
Production & compensation

A live view of provider production and compensation performance — replacing the Power BI pack, built on the same wRVU and statistics data the close posts.

Pharmacy Rebate Tracking

Planned · Oct 2026
Rebate accruals & receipts

Follows manufacturer and GPO rebates from accrual through receipt — earned, invoiced, and collected by market, tied to the dispenses that earned them.

Reporting

Planned · Oct 2026
Market analytics

Cross-market analytics on productivity, revenue, and trends — deeper comparisons and actionable insight.

Clearing & Reconciliation

Planned · Jan 2027
4899 close

Ties out the drug-clearing account each period and surfaces anything that doesn’t reconcile before the books close.

The standards beneath it

What makes the Hub sustainable is the standards layer — one source of truth for how drugs are coded, how providers are named, how charges are set, and how revenue is recognized. Written down, versioned, and identical across every market.

Drug Coding Standard
How J-codes, NDCs, and the Cost Bible resolve to one coded drug.
Provider Naming Standard
One canonical name and ID per provider, mapped to a Sage employee dimension.
Charge Master Standardization
How administered-drug charges are set and kept consistent across practices.
Revenue Recognition Model
The pharmacy close and clearing-account flow behind every journal entry.
Experience

Two decades in physician practice management finance

2021 – Present
U.S. Specialists Management
Physician-owned MSO consolidating multispecialty physician groups — urology, neurosurgery, orthopedics, otolaryngology, and oncology — across ~13 multi-state markets.
CFO, Clinical Services — Corporate2025 – Present
Corporate finance across ~13 markets and nearly $1B in revenue — consolidated reporting and FP&A, the MSO’s first-year audit, accounting centralization and org design, M&A due diligence, treasury and covenant compliance, specialty pharmacy buy-and-bill, and the Finance Hub.
CFO, St. Louis Market2021 – 2025
Embedded through 5x revenue growth ($30M → $150M) across USL, NSL, and SHS — cut AR days 40→29, drove ~25% ancillary-led top-line growth, and secured $40M+ in financing.
2015 – 2021
Insight Medical Genetics — Chicago, IL
CFO · Director of Finance & Controller · Accounting Manager
Co-led 50% revenue growth, supported a $15M PE-backed acquisition, and rebuilt reporting and payer strategy across a six-site clinical and laboratory genetics practice.
2007 – 2014
Associated Urological Specialists — Chicago, IL
Finance & Accounting Manager · Senior Accountant · Staff Accountant
Employee #1 post-merger of six practices; helped develop the ancillary lines into a single ~$20M+ MSO and built an early in-house specialty pharmacy and infusion center — a first buy-and-bill / medically-integrated dispensing build.
MBA, Healthcare Management
Loyola University Chicago (2023)
BA, History
Loyola University Chicago (2007) · Post-Baccalaureate, Accounting
ERP / FinanceSage Intacct, Excel (macros, advanced modeling), Power BI, Tableau, QuickBooks
AutomationPython (pandas, openpyxl), JavaScript / React / SheetJS, AI-assisted finance workflows
PM / EHRVeradigm, Cerner, eClinicalWorks, Epic, Liberty, TELCOR, Phreesia
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