Medical Director, Population Health
Town Square Health is reimagining what healthcare can be. We're building a first-of-its-kind value-based care model with a singular mission: to set the gold standard for how Americans experience healthcare. Our primary care locations offer comprehensive primary care with coordinated specialty support for Medicare-eligible patients, and we're growing fast, with expansion into multiple markets on the horizon. If you're bold, collaborative, and driven to make a real difference in people's lives, we'd love to have you on our team!
This is nota traditional medical director role.
Town Square Health is seeking a Medical Director, Population Health (MD/DO or APP) to serve as the clinical partner to our population health team. This is a hands-on, high-impact role for a value-based care clinician who thrives at the intersection of clinical practice, population health strategy, and operational design. You'll help shape how our first locations deliver care, from day-one workflows to ongoing program optimization, and your work will set the clinical foundation for how we scale.
The ideal candidate brings deep experience in value-based primary care, risk documentation (V28/HCC), Stars/HEDIS performance, and chronic condition management. Experience with integrated Behavioral Health and the IMPACT model is a meaningful plus. You'll lead efforts to design and operationalize population health programs, translate strategy into frontline workflows, and coach providers and care teams to deliver high-quality, well-documented care at scale.
You'll have the opportunity to:
- Shape the clinical care model from the ground up - including the principles and playbook we'll use to scale
- Collaborate with the Director, Risk Adjustment to deliver on our risk documentation strategy and population health program design in a 100% V28 environment
- Coach and develop frontline providers and care teams across risk adjustment, quality, and chronic condition management
- Partner at the highest levels of the organization, including the CEO, CTO, VP of Provider Strategy, and cross-functional leaders
- Help define what exceptional, sustainable value-based care looks like for Medicare patients
What You'll Do
You'll be the clinical anchor for our population health work - setting strategy, designing workflows, coaching teams, and tracking what's working. This role spans a wide surface area by design; we're building something new, and you'll be one of the key people who shapes it. Below is a view into the core areas you'll own.
Risk Documentation Strategy
- Develop our overall risk documentation strategy in collaboration with the Director of Risk Adjustment, ensuring accurate, specific, and compliant clinical documentation in a 100% V28 environment
- Design and maintain provider education and training on risk documentation best practices
- Partner with analytics and population health teams to identify documentation gaps, prioritize outreach strategies, and monitor impact on RAF over time
Population Health & Chronic Condition Management
- Design high-impact, protocolized chronic condition management workflows (e.g., CHF, CKD, diabetes, COPD) that are evidence-based, operationally realistic, and embedded in everyday patient care
- Incorporate Stars/HEDIS measures into daily workflows so that quality performance is built into care.
- Own designing and integrating behavioral health into our model of care, including the operational deployment of the IMPACT model
Clinical Workflow & Population Health Deployment
- Translate population health strategies into actionable, role-specific workflows for physicians, APPs, nurses, and MAs
- Serve as a key liaison between clinical workflow design and center operations, keeping population health strategy connected to frontline reality
- Partner with operations leaders, including the Nursing Practice and Workforce Development Lead, on the deployment of population health programs
Care Model Design & Scaling
- Develop clinical principles for the care model, in collaboration with the CEO, that can support scaling beyond our first location
- Use those principles to build a playbook for all lanes of value-based care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider Strategy & Population Health
Training & Coaching
- Develop and deliver training for providers and care teams on clinical workflows, documentation standards, and population health programs
- Serve as the clinical go-to for frontline teams, offering guidance, feedback, and real-time coaching
- Help build a culture of continuous improvement and accountability around risk documentation, quality metrics, and chronic care outcomes
Cross-Functional Collaboration & KPI Ownership
- Partner closely with Operations, Population Health, Analytics, and Technology to align clinical workflows with performance targets
- Define and track key KPIs within your scope (e.g., HCC documentation, Stars/HEDIS measures, care gap closure)
- Regularly review performance data, identify root causes, and lead action plans to improve outcomes
Who You Are
You're a clinician who thinks in systems. You're as comfortable designing a population health workflow as you are coaching a provider on documentation or presenting a strategy to senior leadership. You bring deep clinical credibility and the operational instincts to translate it into something that actually works at scale.
You thrive in environments where not everything is figured out yet — where your judgment, your relationships, and your ability to move between strategy and execution are what drive results. You lead with clarity and empathy, and you know how to bring a team along with you.
Most importantly, you believe healthcare can be better, and you want to be part of the team proving it.
Qualifications
- MD/DO or Advanced Practice Provider (NP/PA) with active or eligible licensure
- 10+ years of clinical experience, preferably in primary care within a value-based care environment
- Meaningful experience in risk adjustment (HCC/RAF), Stars/HEDIS, and/or chronic condition management - you don't need to have led all three, but you need to understand how they connect
- Proven ability to partner with operations to design, refine, and implement clinical workflows and field programs
- Familiarity with integrated behavioral health models (e.g., IMPACT) strongly preferred
- Strong communicator and collaborator who can influence providers and cross-functional teams in a fast-paced, build-mode environment
- Experience supervising, mentoring, and providing performance management to direct reports
- Strong analytical skills and comfort with data-driven decision-making
- Mission-driven, collaborative mindset and a passion for improving access to high-quality primary care
What We Offer
- Starting salary range of $170,000–$185,000, based on experience
- Competitive performance-based incentives
- Comprehensive benefits package (medical, dental, vision, 401K)
- Flexible hybrid work model, with preference for candidates who can work in-person 1–2 days per week in Chicago, IL
- Opportunity to build something from the ground up
- Direct impact on patient care and outcomes at scale
- High visibility and influence in a growing organization
- Collaborative, mission-driven team
Medical Director, Population Health
Town Square Health is reimagining what healthcare can be. We're building a first-of-its-kind value-based care model with a singular mission: to set the gold standard for how Americans experience healthcare. Our primary care locations offer comprehensive primary care with coordinated specialty support for Medicare-eligible patients, and we're growing fast, with expansion into multiple markets on the horizon. If you're bold, collaborative, and driven to make a real difference in people's lives, we'd love to have you on our team!
This is nota traditional medical director role.
Town Square Health is seeking a Medical Director, Population Health (MD/DO or APP) to serve as the clinical partner to our population health team. This is a hands-on, high-impact role for a value-based care clinician who thrives at the intersection of clinical practice, population health strategy, and operational design. You'll help shape how our first locations deliver care, from day-one workflows to ongoing program optimization, and your work will set the clinical foundation for how we scale.
The ideal candidate brings deep experience in value-based primary care, risk documentation (V28/HCC), Stars/HEDIS performance, and chronic condition management. Experience with integrated Behavioral Health and the IMPACT model is a meaningful plus. You'll lead efforts to design and operationalize population health programs, translate strategy into frontline workflows, and coach providers and care teams to deliver high-quality, well-documented care at scale.
You'll have the opportunity to:
- Shape the clinical care model from the ground up - including the principles and playbook we'll use to scale
- Collaborate with the Director, Risk Adjustment to deliver on our risk documentation strategy and population health program design in a 100% V28 environment
- Coach and develop frontline providers and care teams across risk adjustment, quality, and chronic condition management
- Partner at the highest levels of the organization, including the CEO, CTO, VP of Provider Strategy, and cross-functional leaders
- Help define what exceptional, sustainable value-based care looks like for Medicare patients
What You'll Do
You'll be the clinical anchor for our population health work - setting strategy, designing workflows, coaching teams, and tracking what's working. This role spans a wide surface area by design; we're building something new, and you'll be one of the key people who shapes it. Below is a view into the core areas you'll own.
Risk Documentation Strategy
- Develop our overall risk documentation strategy in collaboration with the Director of Risk Adjustment, ensuring accurate, specific, and compliant clinical documentation in a 100% V28 environment
- Design and maintain provider education and training on risk documentation best practices
- Partner with analytics and population health teams to identify documentation gaps, prioritize outreach strategies, and monitor impact on RAF over time
Population Health & Chronic Condition Management
- Design high-impact, protocolized chronic condition management workflows (e.g., CHF, CKD, diabetes, COPD) that are evidence-based, operationally realistic, and embedded in everyday patient care
- Incorporate Stars/HEDIS measures into daily workflows so that quality performance is built into care.
- Own designing and integrating behavioral health into our model of care, including the operational deployment of the IMPACT model
Clinical Workflow & Population Health Deployment
- Translate population health strategies into actionable, role-specific workflows for physicians, APPs, nurses, and MAs
- Serve as a key liaison between clinical workflow design and center operations, keeping population health strategy connected to frontline reality
- Partner with operations leaders, including the Nursing Practice and Workforce Development Lead, on the deployment of population health programs
Care Model Design & Scaling
- Develop clinical principles for the care model, in collaboration with the CEO, that can support scaling beyond our first location
- Use those principles to build a playbook for all lanes of value-based care (risk adjustment, quality, admission prevention) in collaboration with the VP, Provider Strategy & Population Health
Training & Coaching
- Develop and deliver training for providers and care teams on clinical workflows, documentation standards, and population health programs
- Serve as the clinical go-to for frontline teams, offering guidance, feedback, and real-time coaching
- Help build a culture of continuous improvement and accountability around risk documentation, quality metrics, and chronic care outcomes
Cross-Functional Collaboration & KPI Ownership
- Partner closely with Operations, Population Health, Analytics, and Technology to align clinical workflows with performance targets
- Define and track key KPIs within your scope (e.g., HCC documentation, Stars/HEDIS measures, care gap closure)
- Regularly review performance data, identify root causes, and lead action plans to improve outcomes
Who You Are
You're a clinician who thinks in systems. You're as comfortable designing a population health workflow as you are coaching a provider on documentation or presenting a strategy to senior leadership. You bring deep clinical credibility and the operational instincts to translate it into something that actually works at scale.
You thrive in environments where not everything is figured out yet — where your judgment, your relationships, and your ability to move between strategy and execution are what drive results. You lead with clarity and empathy, and you know how to bring a team along with you.
Most importantly, you believe healthcare can be better, and you want to be part of the team proving it.
Qualifications
- MD/DO or Advanced Practice Provider (NP/PA) with active or eligible licensure
- 10+ years of clinical experience, preferably in primary care within a value-based care environment
- Meaningful experience in risk adjustment (HCC/RAF), Stars/HEDIS, and/or chronic condition management - you don't need to have led all three, but you need to understand how they connect
- Proven ability to partner with operations to design, refine, and implement clinical workflows and field programs
- Familiarity with integrated behavioral health models (e.g., IMPACT) strongly preferred
- Strong communicator and collaborator who can influence providers and cross-functional teams in a fast-paced, build-mode environment
- Experience supervising, mentoring, and providing performance management to direct reports
- Strong analytical skills and comfort with data-driven decision-making
- Mission-driven, collaborative mindset and a passion for improving access to high-quality primary care
What We Offer
- Starting salary range of $170,000–$185,000, based on experience
- Competitive performance-based incentives
- Comprehensive benefits package (medical, dental, vision, 401K)
- Flexible hybrid work model, with preference for candidates who can work in-person 1–2 days per week in Chicago, IL
- Opportunity to build something from the ground up
- Direct impact on patient care and outcomes at scale
- High visibility and influence in a growing organization
- Collaborative, mission-driven team
