Medical Director, Enhanced Care Management

About Zocalo Health

Zocalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. We partner with health plans, providers, and community organizations to deliver culturally competent primary care, behavioral health, and social care.

Our model is built for populations with high medical and social complexity, where fragmented care drives poor outcomes and unnecessary cost. We combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live.

The Role

Zocalo delivers Enhanced Care Management to Medi-Cal members with high medical and social complexity, through care teams of RNs, community health workers, and care coordinators. This role holds clinical accountability for that work.

The organization is moving to a care model in which an RN leads each patient panel. Clinical review of care plans and encounters is a requirement of that model and a condition of several health plan contracts. This role sets the standard for that review, owns the clinical protocols the care teams work to, and serves as the clinical voice in health plan and regulatory conversations.

The role also carries a clinical line: the two nurse practitioners providing clinical oversight across the ECM panel report into it.

Key Responsibilities

• Clinical governance: Care plan and encounter review standards for Enhanced Care Management, sign-off requirements, and the evidence that they are met.
• Clinical protocols: Escalation pathways for the care teams, including the criteria behind patient acuity tiering.
• NP supervision: Direct supervision of the nurse practitioner clinical oversight line.
• External clinical representation: Clinical input into health plan audits, fidelity requirements, and regulatory submissions.
• Clinical quality: Quality measures and the response to gaps identified within them.
• Clinical partnership: Partnership with the Executive Director of Behavioral Health and Care Management on the RN service line, and with the SVP of Care Delivery on care model design.

First Twelve Months

• Review standard: A documented clinical review standard for Enhanced Care Management that meets contractual requirements, is sustainable at scale, and is supported by evidence of compliance.
• Protocols in place: Clinical protocols and escalation criteria applied consistently across counties and health plans.
• Acuity tiering validated: The tiering method clinically validated and aligned with health plan expectations.
• NP capacity deployed to need: Oversight capacity allocated against clinical need rather than historical allocation.
• Quality visibility: A clinical quality view that identifies gaps early enough to act on them.

Qualifications

• MD or DO with an active California medical license.
• Board certification in family medicine, internal medicine, or a related specialty.
• Experience in a medical director or comparable clinical leadership role.
• Experience with Medicaid populations and with complex, high-need patients. CalAIM and Enhanced Care Management experience is a significant advantage.
• Experience with clinical quality measurement, audit, and regulatory requirements.
• Experience supervising advanced practice clinicians.

Preferred Qualifications

• Experience in a tech-enabled or virtual-first delivery organization.
• Experience with value-based or risk-bearing arrangements.
• Experience working alongside community health workers and non-clinical care team members.
• Bilingual in Spanish, or experience serving predominantly Spanish-speaking populations.

What You Can Expect from Zocalo Health

• Equity compensation package
• Comprehensive benefits including medical, dental, and vision
• 401k
• Flexible PTO policy
• Equipment provided for the role