Regional Medical Director - New Braunfels, Texas

InnovaCare Health•Austin, TX

About The Position

The Regional Medical Director provides clinical oversight and medical management for medical directors and physicians assigned to clinics in the designated region. The role ensures participating physicians and providers deliver care that meets standards for quality, timeliness, appropriateness, and defined ICP initiatives, including documentation review, HEDIS gaps, medical cost initiatives, provider productivity, member satisfaction, and recruitment. The position also participates in dispute resolution involving staff, providers, and patients. The role is divided approximately equally between patient-facing clinical duties and administrative responsibilities. Administrative and leadership work includes mentoring and supervising physicians and clinical staff, supporting quality and utilization management initiatives, coordinating with clinic and regional administrators, and helping integrate medical services into ICP’s broader services. The position also supports provider recruitment, performance improvement, patient complaint review, clinical referral review, and ongoing clinical guidance. Physical requirements include lifting up to 50 pounds, pushing or pulling with up to 100 pounds of force, and standing or sitting for extended periods; the role may involve occasional exposure to communicable diseases or bodily fluids.

Requirements

M.D. or D.O. degree from a U.S.-accredited institution, or equivalent licensing required to practice medicine in the U.S. for foreign graduate training.
Board Certified or Board Eligible in Internal Medicine, Family Medicine, and/or Geriatric Medicine.
Valid, unrestricted medical license in the state of employment, or ability to obtain one.
Active, unrestricted DEA license.
Active BLS certification.
Active ACLS certification.
Knowledge of professional medical practices related to treatment.
Knowledge of organizational and medical policies, regulations, and procedures.
Knowledge of medical equipment and instruments and common safety hazards and precautions for establishing a safe medical environment.
Skill in developing and maintaining records, writing reports, and responding to correspondence.
Skill in developing and maintaining medical quality assurance and quality control standards.
Ability to establish and maintain effective working relationships with patients, employees, medical staff, and the general public.
Ability to react calmly, objectively, and effectively in emergency situations.
Ability to communicate clearly with patients, staff, and clients; good telephone manners and etiquette.
Strong organizational skills and attention to detail.
Excellent interpersonal skills and ability to motivate and work effectively with others.
Ability to lift up to 50 pounds and push or pull heavy objects using up to 100 pounds of force.
Ability to stand or sit for extended periods.
Ability to use fine motor skills to operate equipment and/or machinery.
Ability to properly drive and operate a company vehicle.
Ability to receive and comprehend instructions verbally and/or in writing.
Ability to use logical reasoning for simple and complex problem-solving.
Ability to discriminate shades of color when reading a dipstick.

Nice To Haves

Two years of experience in an outpatient setting.
Active, unrestricted Medicare and Medicaid numbers.
Experience managing commercial and Medicare Advantage patients in value-based care.
Knowledge of Medicare coverage and guidelines.
Strong verbal and written communication.
Excellent attention to detail.
Knowledge of diagnostic equipment and procedures.
Good interpersonal skills.
Critical-thinking and problem-solving skills.
Ability to move and manipulate patients.
Ability to multitask in a fast-paced environment.
Computer and technology proficiency, including Microsoft Email, Word, Excel, PowerPoint, and Teams, as well as Athena EMR.

Responsibilities

Oversee and mentor assigned physicians on medical initiatives, care protocols, referral management, and care coordination with care teams.
Work with clinic medical directors, care managers, and utilization management staff to support patient access, consistent quality standards, and cost-effective resource utilization.
Assist clinic administrators with provider scheduling, clinic operations, and use of reports to identify opportunities to improve care, service, and cost-effectiveness.
Lead clinicians and clinical staff in utilization management and quality improvement efforts.
Prepare for and participate in site clinic KPI meetings and attend assigned regional, medical director, and other provider meetings.
Participate in interviews for staff positions and new providers, and in the recruitment and selection of medical providers.
Partner with clinic and regional administrators to reduce medical costs and improve care outcomes.
Help define clinic business goals and engage physician leaders in achieving them; participate in developing and implementing new initiatives.
Communicate pertinent information to medical directors and primary care providers as a liaison.
Mentor providers and help develop future physician leaders through education about managed-care business practices.
Cooperate with and support the ICP Compliance Program and initiatives, policies, and procedures; model appropriate conduct in the clinics.
Attend huddles and clinic meetings and perform other assigned duties.
Supervise medical staff clinically, conduct regular performance appraisals, and provide feedback.
Supervise clinical staff scheduling, call coverage, and leave; oversee continuing professional education, in-service training, and orientation of new medical staff.
Ensure medical services are integrated into ICP’s comprehensive services.
Advise on medical equipment purchases and counsel clinical staff.
Facilitate weekly interdisciplinary medical staff/provider meetings to review up to ten high-risk patients for care-quality gaps and potential interventions.
Assist staff with treatment modalities, including pain injection initiatives relevant to ICP patient populations.
Perform clinical referral reviews for medical appropriateness and review patient complaints.
Review medical staff input and concerns with the associate CMO.
Oversee and maintain performance improvement processes established by the health center, JCAHO, the federal government, and other entities.
Participate in collaborative efforts throughout the office and provide advocacy and steerage for specialty PPN partners.
Develop standards and qualifications for medical personnel.
Provide ongoing clinical guidance and report on clinical activities at Medical Director meetings.
Periodically review practice management functions and serve as a liaison between medical staff and administration.