Medical Director - Sphere Senior

Sphere Senior is an AI-native, home-based primary care program built for the most medically complex older adults, the ones who fall through the cracks of traditional healthcare. We deliver primary care, complex care management, care transitions support, and serious illness/palliative care directly in the home, because that's where our patients live and where care actually matters.

Our clinical intelligence platform, SphereOS, powers everything behind the scenes: real-time risk stratification, AI-assisted documentation, care gap detection, and population-level outcome tracking. We're not digitizing an old model, we're building the clinical operating layer the aging population has always deserved.

We're early, intentional, and growing. The team you'll join is small, highly capable, and deeply mission-driven.

The Medical Director is the clinical foundation of Sphere Senior, the standard-setter, the supervising physician, the person payers trust, and the clinician our NPs and care managers rely on when cases get hard.

This is a part-time, foundational hire. In two 12-hour shifts per week, you will carry a direct patient panel (in-home visits) while simultaneously owning clinical governance, NP supervision, and quality program oversight. That structure is intentional: we believe the best Medical Director stays close to patients, not just dashboards.

You will help design the care model, protocols, staffing architecture, clinical quality infrastructure, from the ground up, with the flexibility of a part-time commitment and the impact of a full-time mission.

• Set, implement, and continuously refine evidence-based clinical protocols, care pathways, and quality standards
• Provide direct clinical supervision and collaborative practice oversight for all NPs and APPs, including serving as supervising/collaborating physician of record where required by state law
• Lead clinical governance structures: M&M review, utilization review, care committee meetings, and incident reporting
• Own program-level quality metrics: 30-day readmission rates, ED utilization, HEDIS/Stars performance, ADL/functional outcomes, and patient safety events
• Lead advance care planning, goals-of-care conversations, and palliative/serious illness protocol development
• Partner with SphereOS to monitor population-level risk panels, close care gaps, and drive proactive, data-informed outreach

• Conduct in-home visits with a complex, high-needs senior population across two clinical shifts per week
• Diagnose and manage multi-morbidity: CHF, COPD, dementia, diabetes, frailty syndromes, CKD, fall risk, and end-of-life care trajectories
• Lead complex case reviews and provide real-time clinical consultation to NPs and care managers during shift hours
• Own transitions-of-care workflows: post-hospitalization follow-up, SNF discharge bridge visits, and ED diversion planning

• Partner with the CEO and Geriatric Care Operations Director on clinical hiring standards, onboarding, and credentialing
• Represent Sphere Senior in payer meetings, ACO partnerships, health system negotiations, and referral partner relationships
• Contribute clinical input to value-based contract design: MSSP, ACO REACH, Medicare Advantage risk arrangements, and bundled payment models
• Leverage SphereOS data to inform staffing ratios, visit frequency protocols, and escalation thresholds
• Support regulatory compliance, state licensure filings, clinical policy documentation, and audit-readiness

• MD or DO — board-certified in Internal Medicine, Family Medicine, or Geriatrics
• Active, unrestricted medical license in state(s) of operation (multi-state or compact licensure a plus)
• Active DEA registration
• 5+ years of clinical practice; at least 2 years in home-based primary care, PACE, SNF, or complex geriatric care settings
• Demonstrated experience supervising or collaborating with NPs/APPs
• Strong working knowledge of value-based care mechanics: HCC coding, risk adjustment, Medicare/Medicaid programs, and quality measure frameworks
• Comfort with AI-assisted clinical tools, telehealth, and digital-first workflows

• Board certification or fellowship in Geriatric Medicine (CAQ-G) or Hospice & Palliative Medicine
• Prior experience as a Medical Director, Clinical Lead, or Program Director in a home-based, PACE, or value-based care setting
• Hands-on experience with ACO/MSSP, ACO REACH, or MA risk contracting
• Palliative care training, certification, or significant practice experience
• Familiarity with quality improvement methodology (PDSA, Lean, or similar)
• Interest in or experience with clinical AI tools, LLM-assisted documentation, or digital health platforms

• 2 × 12-hour clinical shifts per week — field-based, in-home patient care
• Clinical supervision, governance, and leadership responsibilities embedded within shift hours (not additive)
• On-call escalation support shared with APP team via structured, low-burden rotation
• Weekend coverage expectations discussed transparently at offer stage

Most part-time Medical Director roles are advisory at best, you sign off on protocols you didn't write and supervise NPs you rarely see. This is different.

You'll have real clinical ownership, real patient relationships, and real influence over how a next-generation senior care model is built. The part-time structure means you can maintain other clinical commitments while being a genuine architect of something that matters.

If you've ever thought "I wish someone would do home-based primary care the right way", this is your chance to be the person who does.