Medical Director - Texas Health Care PLLC

The Medical Director will lead clinical strategy and assess value-based opportunities (e.g., palliative care, post-acute care, care transitions) to address the complex needs of patients. This role focuses on improving health outcomes and reducing avoidable utilization at the population level. The Medical Director will oversee the development, implementation, evaluation, and continuous refinement of care management programs and strategic partnerships to build a comprehensive complex care portfolio, improving outcomes and utilization for patients in the Privia Medical Group North Texas market. Working closely with senior clinical, operational, and cross-functional teams (finance, analytics, IT, operations, and training), the Medical Director will ensure program execution and continuous improvement, maximizing impact and effectiveness.

A successful leader will develop and implement frameworks to measure program impact and drive clinical and medical trend value creation.

Key Responsibilities

• Innovative Care Models: Develop and implement value-based care models focused on addressing patients' complex needs, emphasizing whole-person care, quality, and cost efficiency.
• Adverse Event Prevention: Lead interventions to reduce avoidable ER visits, hospitalizations, readmissions, procedures, complications, and mortality, while reducing costs.
• Data-Driven Opportunity Assessment: Collaborate with executive leadership and primary care providers (PCPs) to identify new program opportunities using data modeling and analysis.
• Clinical Excellence: Foster a culture of clinical excellence by promoting evidence-based practices and outcomes-driven frameworks.
• Performance Monitoring: Track and analyze population health and program metrics, driving continuous improvement efforts.
• Policy Development: Partner with the program manager to create, review, and implement program policies and procedures.
• Regulatory Awareness: Monitor CMS guidelines, market conditions, and state regulations to inform value-based care strategies.

Clinical Oversight & Direct Patient Care

• Lead root cause analysis with interdisciplinary teams to evaluate potentially avoidable utilization events.
• Participate in routine interdisciplinary team (IDT) meetings to guide patient-specific interventions. This will help to
• Provide training and evaluation on advance care planning for patients and the care team.
• Offer ongoing clinical education and consultation to the interdisciplinary team.
• Provide oversight and guidance to Advanced Practice Providers (APPs) on symptom and medication management.
• Collaborate with the program manager to assess and improve patient/PCP satisfaction with the program.
• Provide physician services in patient homes to enhance outcomes and support program goals.

Required Qualifications

• MD/DO with 5-7 years of post-graduate experience, including direct experience in leading clinical program development, implementation, and evaluation in population health at a regional level.
• Hands-on experience with complex care management and value-based care programs, particularly in senior care and/or Medicare.

Knowledge, Skills, Abilities & Competencies

• Passion for improving health outcomes in economically sustainable ways, with expertise in clinical innovation and care model development.
• Strong understanding of population health drivers (clinical, quality, and financial) in full-risk care delivery, particularly in Medicare/senior care.
• Ability to guide clinical operations, prioritize initiatives, and develop effective processes.
• Proficient in word processing, database management, spreadsheets, presentation creation, and report writing.
• Skilled in tracking and evaluating outcomes and performing rapid-cycle process improvement.
• Expertise in complex clinical decision-making, patient engagement, and care management.
• High financial acumen with the ability to assess the financial impact of care management programs.
• Proven leadership experience in building and leading high-performing teams.
• Excellent communication and interpersonal skills, with the ability to engage stakeholders at all levels.
• Knowledge of health care regulations and policies related to care transitions and post-acute care management.