As the System Medical Director, you will be the physician leader for Apogee’s interventional psychiatry program (TMS and Spravato) and for quality of care across all of our clinics. You will set the clinical standard for these treatments, supervise and support our advanced practice providers (APPs), and help bring procedural services to new communities as Apogee grows, opening the door to life-changing care for patients who have not found relief elsewhere.
The role is split evenly between leadership (50%) and direct patient care (50%), so you stay close to patients while shaping how care is delivered across the practice. It is ideal for a board-certified psychiatrist (MD or DO) with at least 5 years of post-residency experience, hands-on experience with interventional treatments, and a passion for expanding access to effective care.
Reports to:
Chief Medical Officer – Clinical & Admin
Senior Director of Clinical Operations – Personnel
Direct reports:
APPs under the System Medical Director’s supervision or practice agreements – Clinical
TMS/Spravato treatment staff – Clinical (protocols and competency); Admin & Personnel stay with the Provider Support Manager
Prior Authorization Specialist – Admin & Personnel
Collaborates with:
Clinical Services Manager, Provider Support Manager, Regional Clinic Manager, Clinical Quality Advisor, Director of Medical Education, Clinic Leads, Recruiting Team
Responsibilities
ADMINISTRATIVE LEADERSHIP — Approximately 50% of the role.
Interventional Treatment Service Line
- Service Line Leadership: Serve as the physician owner of TMS and Spravato at every site, accountable for protocols, patient selection, safety, and outcomes.
- Procedural Operations: Direct day-to-day TMS and Spravato operations, including scheduling, authorizations, REMS documentation workflows, and procedural revenue tracking.
- Prior Authorizations: Oversee the Prior Authorization Specialist and the end-to-end authorization process for procedural referrals, monitoring approval rates, turnaround times, and payer trends.
- Program Excellence & Compliance: Enforce standardized clinical protocols and workflows at every site in line with FDA labeling, payer medical policy, and state regulations. Ensure every Spravato site maintains current REMS certification and meets REMS monitoring and documentation requirements.
- Outcomes & Success Metrics: Track program KPIs, such as retention and remission rates, to demonstrate the clinical effectiveness of TMS and Spravato.
- Patient Experience: Set the standard for each stage of the interventional patient journey, from referral and consult through authorization, treatment, and follow-up, and close gaps identified through patient feedback and outcomes data.
- Spravato/TMS Training: Own training and competency sign-off for prescribers, the LPN, and CMAs, and maintain training records.
- Vendor & Pharma Partners: Serve as clinical lead for J&J/Janssen, Welcony (TMS), the Spravato REMS program, and Besse/Nucleus, and evaluate new devices, therapies, and partner terms with the CMO.
- Procedural Revenue Oversight: Track procedural volume, authorization approvals, utilization, and revenue by site. Work denials with the Prior Authorization Specialist and billing, including physician peer-to-peer reviews on appeals.
- Procedural Program Expansion: Partner with the CMO to launch the procedural program at new sites and in new states, from site readiness, equipment, staffing, and REMS certification through go-live. Interview candidates for procedural roles with the Recruiting Team.
Quality of Care & APP Supervision
- Quality Care Initiatives: Serve as physician lead for quality of care. Define clinical quality measures, review results, and drive improvement plans with the CMO, the Clinical Quality Advisor, and the Senior Director of Clinical Operations.
- Chart Review & Risk Management: Review prescriber charts at the frequency set by the CMO and Compliance. Investigate adverse clinical events, resolve clinical care complaints, and escalate potential legal issues.
- MD Clinical Education & Corrective Action: Lead peer-to-peer training and provider re-education when chart reviews, quality data, or incidents reveal gaps in clinical practice. Document corrective action plans and track them through resolution.
- Clinical Standards & Policies: Provide physician input on system clinical policies, confirm they align with each state’s regulations, and escalate exceptions.
- Multistate APP Supervision: Serve as supervising or collaborating physician for APPs in North Carolina, Virginia, and Tennessee. Maintain the required practice agreements, meet each state board’s requirements (e.g., QI meetings, chart review), and keep records current in Atlas.
- Clinical Escalation: Serve as the physician escalation point for Clinic Leads and prescribers on complex cases and participate in Consult Lunches.
- Clinical Support Back-up: Provide daytime on-call back-up for unavailable providers, including crisis calls.
- Reporting: Report service line, prior authorization, and quality metrics to the CMO each month.
CLINICAL DELIVERY — Approximately 50% of the role.
- Direct Patient Care: Maintain a psychiatric caseload in accordance with available non-administrative time.
- Clinical Model: Model best practices in documentation, patient engagement, and coding integrity for peer providers.
Qualifications
- Licensure: MD or DO with current, unrestricted licenses in North Carolina, Virginia, and Tennessee, or the ability to obtain them within 90 days of hire. Active DEA registration in each state of practice; willing to add states as Apogee expands.
- Board Certification: Board certification in psychiatry following an accredited psychiatry residency.
- Experience: 5+ years post-residency, including 2+ years as a physician leader (medical director, service line lead, or similar).
- Interventional Psychiatry: Hands-on experience prescribing and overseeing TMS and Spravato is essential. TMS training or certification preferred; otherwise, must be completed within 90 days of hire.
- Experience as a supervising or collaborating physician for NPs and PAs.
- Experience leading quality improvement, chart review, or peer review.
- Preferred: experience managing pharma or device partners, REMS programs, and prior authorization for interventional treatments.
- Ability to travel to clinics in other states.
- Familiarity with the Principles of Medical Ethics of the American Medical Association and the Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry.
- Ability to lead, supervise, and collaborate cross-functionally.
- Commitment to Apogee’s Mission & Vision of Making Each Day Better.