Description

The Senior Medical Director, House Calls & GUIDE is a senior clinical executive and member of the leadership team responsible for setting the overall clinical direction of AuthoraCare’s House Calls practice and Medicare GUIDE dementia care program. 

This leader ensures clinical excellence, regulatory compliance, evidence-based practice standards, and measurable performance outcomes across the service line. The role integrates clinical strategy with operational execution through a formal dyad leadership model with the Chief Operating Officer (COO), sharing joint accountability for quality, growth, financial sustainability, and regulatory readiness. 

• The Senior Medical Director serves as the senior clinical authority for the House Calls practice and GUIDE program, ensuring care delivery aligns with AuthoraCare’s mission, value-based care strategy, and long-term growth objectives. 

The balance of leadership and direct clinical responsibilities will be defined at time of hire and may be adjusted based on service line needs and strategic priorities.

 Scope of Authority

• The Senior Medical Director holds primary clinical authority within the House Calls and GUIDE programs, including: Interpretation and modification of clinical protocols and care pathways in alignment with regulatory and evidence-based standards 
• Resolution of complex clinical disputes 
• Supervisory authority consistent with NC Medical Board requirements for NPs and PAs 
• Oversight of prescribing standards, including PDMP compliance and controlled substance stewardship 
• Authority to establish and revise clinical documentation standards supporting billing integrity and Place of Service compliance 
• Clinical governance oversight of the Medicare GUIDE program 
• Clinical decision-making occurs in partnership with operational and quality leaders within the dyad framework. 

Clinical Practice Expectations

• The Senior Medical Director maintains an active clinical practice within the House Calls and/or GUIDE programs. 
• Approximately 60% of the role is dedicated to direct patient care. Carry a panel of patients, work 3 days clinical and 2 days administrative
• Approximately 40% of the role is dedicated to executive leadership, strategic planning, provider oversight, quality improvement, regulatory compliance, and dyad collaboration. 
• Clinical productivity expectations will be defined in collaboration with the COO and Program Director. 
• Leadership deliverables and performance expectations will be evaluated annually and aligned with service line goals. 
  Will participate in the house calls practice on-call rotation
  
  

Dyad Leadership with Chief Operating Officer

• The Senior Medical Director operates in a formal dyad leadership structure with the COO to integrate clinical strategy with operational execution.
• Within this model: The Senior Medical Director holds primary accountability for clinical standards, medical decision-making, provider oversight, and evidence-based practice. 
• The COO holds primary accountability for operational infrastructure, workforce design, financial performance, and administrative systems. 

Both leaders share joint accountability for: 

o    Service line performance and sustainability 

o    Quality outcomes and patient experience 

o    GUIDE program performance 

o    Regulatory readiness 

o    Provider engagement and culture 

• Major strategic or structural decisions impacting the service line are reviewed collaboratively within the dyad framework to ensure alignment between mission, margin, and clinical excellence. 

  Key Responsibilities

Clinical Leadership & Strategy 

• Develop and communicate the clinical vision and strategy for House Calls and GUIDE. 
• Promote adoption of evidence-based practice standards across the service line. 
• Foster a culture of accountability, collaboration, and mission-driven clinical excellence. 
• Participate in organizational strategic planning and program development to support growth of home-based primary care and dementia services. 
• Align clinical programs with value-based contracting and risk-bearing arrangements. 
• Partner with analytics teams to define and leverage clinical performance dashboards and actionable metrics. 
• Co-develop annual service line goals, performance metrics, and strategic initiatives within the dyad framework. 

Regulatory & Compliance Oversight 

Ensure compliance with all applicable federal and state requirements, including: 

• CMS Conditions of Participation 
• Medicare GUIDE program requirements 
• NC Medical Board supervisory requirements for NPs/PAs 
• PDMP oversight and prescribing regulations 
• Documentation standards supporting billing integrity and risk-adjustment accuracy 
  Place of Service compliance 

Audit readiness and fraud, waste, and abuse prevention standards 

Quality Improvement & Outcomes Accountability 

In partnership with the Lead APP and Quality teams, provide executive oversight of QI initiatives with measurable improvement in:

• Emergency Department utilization
• Hospital admissions and 30-day readmissions 
• Hospice conversion rates
•  Polypharmacy review and deprescribing initiatives 
• Advance Care Planning (ACP) completion rates 
• GUIDE-specific CMS performance metrics 
• CAHPS and patient experience scores 
• Lead interdisciplinary review processes for adverse outcomes and high-risk cases. 

Ensure patient safety and clinical excellence remain organizational priorities. 
 

Population Health & Risk Oversight 

• Oversee risk stratification methodologies for the House Calls population. 
• Participate in high-risk patient review processes. 
• Monitor utilization management trends and develop clinical interventions. 
• Lead deprescribing initiatives for medically complex and frail populations. 
• Ensure clinical oversight supports value-based care performance and risk-based arrangements. 
    

Provider Oversight & Workforce Development 

• Supervise and evaluate performance of NPs, PAs, and House Calls providers. 
• Establish objective and auditable clinical performance standards. 
• Conduct regular chart reviews to ensure continued clinical excellence. 
• Support onboarding and clinical competency development of new providers. 
• Provide mentorship and professional development pathways for advanced practice providers. 
• Conduct interdisciplinary meetings and educational sessions focused on patient-centered care. 

Medicare GUIDE Program Oversight 

• Ensure GUIDE participants meet CMS programmatic eligibility requirements. 
• Ensure comprehensive care planning, interdisciplinary oversight, and documentation standards are met. 
• Ensure caregiver engagement standards are achieved. 
• Monitor GUIDE performance metrics and ensure audit readiness.  

Operational & Financial Collaboration 

• Partner with the COO and Program Director to ensure clinical performance aligns with fiscal sustainability and service line growth goals. 
• Participate in joint clinical-operational reviews assessing growth, utilization trends, workforce needs, and risk-based performance metrics. 
• Inform leadership regarding clinical implications of expansion opportunities, partnerships, and innovative payment models. 
• Collaborate with the VP, Hospice Medical Affairs to support organization-wide clinical initiatives. 
    

Requirements

Education and Experience:

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO), preferably with a focus on geriatric populations and active license to practice and prescribe in the State of North Carolina.
• Minimum of five (5) years of experience in chronic and terminal patient care, including frail and elderly populations.
• Ability to work closely with senior leadership and communicate with medical advisors, key opinion leaders and medical societies
• Educate payers and other stakeholders via presentations on clinical standards and needed improvements (practice and providers) as well as value-based care programs
• Ensure the company provides clinically sound and ethical care

Required Skills/Abilities:

• Exceptional interpersonal and communication skills. 
• Strategic thinker with strong data literacy.
• Ability to manage competing priorities in a dynamic environment. 
• Strong organizational and prioritization skills. 
• Sound judgment and ability to work independently and collaboratively. 
• Commitment to confidentiality, ethical practice, and integrity. 
• Ability to concentrate with large volumes of work, handle pressure of deadlines, good judgment, ability to follow procedures, ability to work independently and with frequent interruptions.
• Read, write, and speak in English; using telephones, computers and other mechanical means complete the recording and follow up documentation responsibilities of the job. 
• Bend and stoop frequently; perform repetitive hand/wrist movement; mobility to climb stairs; walk distances; move around buildings.
•  Must be able to travel to, enter, and function in the homes of any patient/caregiver within the service area. 
• Utilize correct body mechanics in lifting in excess of 30 lbs. to provide care, treatment and/or services including ability to move pieces of durable medical equipment and potentially heavy patients. 

Other:

• Valid state-issued driver's license required.  
• Must carry automobile liability insurance at limits required by agency.  
• Must have own transportation.