Director of Practice Operations / Growth & Administration Lead

Director of Practice Operations / Growth \& Administration LeadRivertowns Medicine – Concierge Internal Medicine Location: Tarrytown, NY / Southern Westchester County Work Setting: Primarily in\-person Schedule: Approximately 30–40 hours/week during the initial 60–90 day stabilization period; schedule may adjust over time based on practice needs, performance, and growth Compensation: $55–$75/hour, commensurate with experience and demonstrated ability Employment Type: Hourly, non\-exempt to start Start Date: As soon as the right candidate is available About Rivertowns Medicine Rivertowns Medicine is a growing concierge internal medicine practice in Southern Westchester County. We provide highly personalized adult primary care with an emphasis on access, responsiveness, careful follow\-through, and strong doctor\-patient relationships. At Rivertowns Medicine, high\-quality medicine is our product. In a growing and increasingly competitive concierge market, our long\-term advantage will not be gimmicks or volume. It will be careful, evidence\-based, compassionate care delivered with excellent communication, reliable systems, and thoughtful follow\-through. We believe profits follow quality, not the other way around. The practice is built around the idea that good medicine can still be meaningful, personal, intellectually serious, and enjoyable to provide. The practice is entering its next phase of growth. We are looking for a senior, hands\-on Director of Practice Operations who can stabilize and strengthen day\-to\-day operations while helping build the infrastructure needed to support future growth, including additional staff, additional physician capacity, expanded office space, and possible new service lines. This is not a traditional “office manager” role. This is a role for someone who notices open loops, owns them, and makes sure they close. The Opportunity The right person will help run the current practice while also helping to build the next version of it. In the short term, this role will involve hands\-on operational repair: improving workflows, clarifying responsibilities, supervising staff, tracking patient communication, organizing administrative systems, tightening vendor and account management, and making sure unresolved tasks do not disappear. Over time, the role may evolve into a broader practice leadership position involving hiring, onboarding, marketing, expansion planning, office build\-out coordination, technology implementation, membership\-platform transitions, and support for additional physicians and new service lines. This is an opportunity for someone who wants meaningful responsibility, direct access to the physician\-owner, and the chance to help shape a small but growing medical practice. The initial stabilization period will require energy, focus, and hands\-on problem\-solving. The goal is to build systems that make the practice calmer, more reliable, and more sustainable for patients, staff, and the physician\-owner. What We Need We need someone who can bring order, judgment, and follow\-through to a busy concierge practice. The ideal candidate understands that in a medical office, “filed,” “forwarded,” “delegated,” or “put in a folder” is not the same as handled. Many tasks will be completed by Medical Assistants, front\-desk staff, vendors, or outside partners, but the Director of Practice Operations must make sure those tasks are assigned clearly, tracked reliably, escalated when needed, communicated appropriately, and closed\-looped. This role requires someone who can distinguish routine administrative work from time\-sensitive patient\-facing issues, supervise staff directly, document expectations clearly, conduct performance evaluations, and hold people accountable with clarity, fairness, and consistency. Key Responsibilities Day\-to\-Day Practice Operations Oversee the daily administrative operations of a concierge internal medicine practice. Create and maintain reliable task\-management systems so pending items are visible, assigned, followed, escalated when needed, and completed. Ensure patient calls, portal messages, outside records, lab results, refill requests, forms, prior authorizations, billing issues, and insurance updates are tracked and closed\-looped. Distinguish routine administrative items from issues requiring same\-day physician attention or patient/family follow\-up. Identify operational bottlenecks and fix them before they become patient\-service failures. Monitor daily workflows, recurring tasks, and end\-of\-day handoffs to ensure unresolved items do not disappear. Maintain a calm, organized, high\-functioning front\-office environment. Patient Communication and Practice\-Wide Messaging Coordinate patient\-facing communications, including practice announcements, holiday schedules, vaccine clinics, policy updates, membership communications, and other group notifications. Draft, organize, schedule, and send patient email communications or “blast” notifications when appropriate. Ensure patient communications are clear, accurate, timely, professional, and consistent with the practice’s tone and standards. Develop workflows for patient and family inquiries so messages are acknowledged, routed appropriately, followed, and closed\-looped. Ensure that patient\-facing staff can distinguish routine communication from urgent or time\-sensitive issues requiring same\-day attention, and monitor that this judgment is applied reliably. Help maintain patient trust by ensuring that communication from the office is reliable, organized, and responsive. Phone System and Front\-Office Workflow Oversee the practice’s phone\-system workflows, including call routing, voicemail, phone trees, call\-handling protocols, scripts, troubleshooting, and vendor support. Ensure the phone system supports excellent patient access without creating confusion, dropped messages, or unclear responsibility. Develop and enforce call\-handling workflows so calls are documented, assigned, escalated when needed, and closed\-looped. Train and monitor staff on how calls should be answered, documented, routed, escalated, and followed through. Help evaluate whether additional phone support, virtual receptionist services, call recording, transcription, AI summaries, or other tools would improve access, workflow, accountability, and patient service. Staff Supervision, Performance Management, and Accountability Supervise administrative and clinical support staff, including Medical Assistants and front\-desk staff. Clarify roles, responsibilities, daily priorities, and recurring workflows. Implement checklists, task lists, and daily review processes. Provide clear, timely feedback and coaching to staff so that performance concerns are addressed directly rather than allowed to accumulate without structure. Establish and maintain a structured staff performance\-management process, including onboarding check\-ins, periodic performance evaluations, written expectations, corrective feedback, corrective action plans when needed, meeting notes, records of staff coaching or discipline, and documentation of follow\-up. Help prepare and conduct formal performance reviews in coordination with the physician\-owner. Help recruit, interview, onboard, train, and manage additional staff as the practice grows. Create a culture of ownership, accuracy, follow\-through, and patient\-centered service. Administrative, Financial, and Vendor Operations Manage or coordinate vendor relationships, office accounts, subscriptions, passwords, two\-factor authentication, and administrative access. Coordinate with payroll, accounting/bookkeeping, billing support, banking contacts, software vendors, and practice partners. Maintain organized records for banking, payroll, bills, contracts, subscriptions, renewals, and recurring obligations, and ensure that practice bills are reviewed, approved, and paid on time. Support QuickBooks and financial workflow organization in coordination with accounting professionals. Document key business systems, logins, workflows, deadlines, and recurring obligations so they are not dependent on one person’s memory. Help manage and improve workflows involving electronic medical records, billing support, membership administration, and vendor platforms. Ensure that administrative and financial tasks are assigned, tracked, followed up, and completed reliably. Technology, Systems, and AI\-Enabled Workflow Evaluate, implement, and maintain operational tools that improve reliability, accountability, patient communication, staff efficiency, and practice oversight. Assess new systems, including AI\-enabled tools, call transcription, task management, scheduling support, patient communication tools, workflow automation, and reporting dashboards. Evaluate new tools for privacy, security, reliability, staff adoption, cost, and practical fit within a medical practice. Help train staff on new systems and monitor whether tools are being used consistently and correctly. Create simple systems that people actually use, rather than complicated systems that fail in real life. Growth and Strategic Projects Help design the staffing structure needed to support a growing concierge medical practice. Support recruitment and onboarding of additional physician(s), Medical Assistants, front\-desk staff, and administrative support. Help evaluate marketing and advertising strategies in an increasingly competitive Westchester concierge medicine market. Coordinate planning for a potential office move or expansion, including space planning, vendor coordination, build\-out planning, furniture and equipment needs, technology needs, and workflow design. Help plan and execute future transitions involving membership administration, billing workflows, patient communication systems, vendor relationships, and practice\-management platforms. Explore and evaluate potential future service lines, such as subleasing space to other medical professionals, infusion services, or other ancillary offerings. Build scalable systems so the practice can grow without losing reliability, culture, or clinical quality. Ideal Qualifications Significant experience in medical practice operations, healthcare administration, ambulatory\-care management, or high\-service professional office operations. Prior experience managing staff in a medical, healthcare, or high\-service professional setting. Experience conducting employee performance evaluations, documenting performance concerns, and managing corrective action plans is strongly preferred. Strong judgment about urgency, escalation, patient communication, delegation, and follow\-through. Experience creating workflows, checklists, task systems, and accountability structures. Excellent written and verbal communication skills. Strong organizational skills and attention to detail. Ability to handle confidential patient, personnel, financial, and business information with discretion. Comfort working in a small practice where the Director must both lead and do hands\-on work. Comfort learning and working with operational systems, including electronic medical records, Microsoft Office/Google Workspace\-style tools, spreadsheets, phone systems, practice\-management systems, and vendor portals. Experience with Epic, QuickBooks, payroll systems, Voice over Internet Protocol phone systems, medical billing workflows, membership\-based medicine, or concierge medicine is helpful but not required. Experience supporting growth, hiring, marketing, office expansion, build\-out, or new service\-line development is highly valued. Candidates with strong operational, management, communication, and systems experience outside of healthcare are encouraged to apply if they are willing to learn the specific workflows, terminology, compliance expectations, and patient\-service standards of a medical practice. Required Attributes The successful candidate must be: An owner of open loops: You do not assume something is handled because it was forwarded, scanned, filed, delegated, or mentioned. You confirm that it is actually resolved. Hands\-on: You are willing to fix the spreadsheet, call the vendor, check the fax, find the record, update the task list, troubleshoot the phone system, and then build a better system so the same problem does not recur. A practical systems builder: You can create simple workflows that people actually follow. Comfortable managing people: You understand that managing people includes not only being supportive, but also setting expectations, documenting performance, giving direct feedback, conducting performance reviews, and following through. Able to distinguish urgency: You understand that some items can wait, while others require same\-day escalation or patient follow\-up. A strong communicator: You communicate clearly, directly, and professionally with patients, staff, vendors, and the physician\-owner. Discreet and professional: You understand that confidentiality applies to patient information, personnel issues, finances, and business strategy. Technologically curious but practical: You are comfortable evaluating new systems, including AI\-enabled tools, but you care more about reliability, privacy, and workflow fit than novelty. Mission\-aligned: You believe excellent operations exist to support excellent care. The goal is not growth for its own sake; the goal is to build a practice whose quality, reliability, and patient trust make thoughtful, sustainable growth necessary. Schedule and Role Evolution This role is expected to require approximately 30–40 hours per week during the initial stabilization period, likely the first 60–90 days, while the practice strengthens core systems and resolves existing operational gaps. After that period, the schedule may adjust based on practice needs, performance, and the next phase of growth. The role may settle into a reduced schedule or grow into a full\-time senior operations leadership position as the practice expands. Candidates should be comfortable with a role that may evolve over time. Compensation and Benefits Compensation is expected to be $55–$75/hour, commensurate with experience and demonstrated ability. The role will begin as hourly and non\-exempt. Overtime must be approved in advance. Benefits currently include: Paid time off, provided as 20 all\-purpose PTO days annually for a full\-time schedule, prorated based on actual schedule; Paid federal holidays when the office is closed. Health insurance and retirement benefits are not currently offered. The practice intends to revisit benefits as staffing and practice growth allow. Application Questions Please include a resume and brief cover note. In your cover note, please answer the following: Describe a time you inherited a disorganized office, workflow, or team and created structure. A patient’s spouse calls at 9:45 AM asking for outside lab results. The results arrive by fax at 10:30 AM and are scanned into the chart. What steps do you take before the end of the day? What does “closing the loop” mean to you in a medical practice? Describe your experience supervising staff, holding people accountable, conducting performance evaluations, documenting concerns, and managing corrective feedback or corrective action plans. Describe your experience with patient communications, office\-wide announcements, phone systems, vendor portals, electronic records, spreadsheets, or other operational tools. What interests you about helping a small concierge medical practice strengthen its operations, support excellent care, and grow thoughtfully? Why This Role Matters Rivertowns Medicine is built on trust, responsiveness, clinical judgment, and careful follow\-through. Our patients expect excellent medical care and a high level of service. The Director of Practice Operations will play a central role in making sure the practice delivers on that promise every day. This is a high\-trust, high\-impact role for someone who wants to help build something durable, organized, humane, and excellent — a practice where strong operations support high\-quality medicine. Pay: $55\.00 \- $75\.00 per hour Benefits: Paid time off Application Question(s): How much experience do you have designing systems, monitoring systems, and making sure all loops are closed? Experience: Operations management: 3 years (Preferred) * Team management: 3 years (Preferred) Work Location: In person