Regional Managing Director — Care-Delivery Network

The mandate

A regional care network has reached the limit of managing access through local improvisation. Some communities wait for specialist review while capacity remains underused elsewhere; transfer decisions depend on personal relationships; and individual sites protect their schedules even when the regional pathway would benefit from sharing. The board requires a Regional Managing Director to create one accountable operating region.

Approximately 1,500 employees and material partners deliver ambulatory, procedural, post-acute and community-linked services from Boston across the wider US region. The Managing Director holds regional performance, people, capital, access and service accountability, reporting to the Group board and Group Chief Executive. Medical and nursing leaders retain professional authority, but the Managing Director must ensure that clinical standards can be delivered with available capacity.

The immediate work is a demand-and-capability census. Headcount, rooms and nominal appointment slots do not reveal usable capacity. The region needs to understand which clinicians, equipment, support skills and downstream services are available by pathway and time. Demand should be separated by urgency, complexity, geography and likely duration rather than averaged into monthly activity.

Referral queues will be governed regionally. The Managing Director will establish common acceptance information, clinical prioritisation, wait-list validation and responsibility when a site cannot accept a case. Patients should not restart intake merely because another location has capacity. Transfers require confirmed receiving ownership, transport arrangements and return communication.

Local leadership accountability is uneven. Some executives operate their site as a complete business; others rely on central functions to resolve daily constraints. The replacement leader will define a regional operating contract for site, clinical and functional leaders. It will state which measures they own, when they must request help and what repeated failure means for resources or role suitability.

Workforce deployment must become more portable without destabilising teams. Cross-site coverage may relieve a bottleneck, but travel, credential scope, orientation and continuity matter. The Managing Director will build voluntary and planned mobility around defined competencies, using temporary deployment to transfer capability rather than create permanent dependence. Premium labour will be reduced only after safe establishment is demonstrated.

The network has several physical-capacity proposals. Before approving construction or leases, the leader will test operating hours, schedule design, cancellation, turnover, equipment uptime and clinician availability. Existing assets should be released where credible. When new capacity is necessary, the case must include the entire pathway, staffing ramp and the demand source it will serve.

Access redesign includes patients unable to travel or use digital channels easily. Regional consolidation can improve utilisation while increasing burden on vulnerable populations. The Managing Director will quantify travel, language and support needs, then consider outreach, transport, virtual follow-up or local partnerships. These mitigations belong in the operating and financial case, not an appendix after the decision.

Service reliability requires daily management at the constraint. Leaders will review aged referrals, unfilled priority slots, cancellations, delayed discharge and capacity lost to equipment or staffing. Measures must prompt a decision. The region will abandon lengthy retrospective calls that catalogue variance without changing the next day's plan.

Payer arrangements differ across the footprint. Moving care between sites can alter authorisation or reimbursement even when clinically sensible. The Managing Director will ensure access teams identify these constraints early and commercial leaders redesign contracts that obstruct regional pathways. Patients must receive clear information rather than discovering financial barriers after transfer.

Quality and access will be reviewed together. Filling more slots is not improvement if follow-up weakens or staff rush assessments. The regional scorecard will include appropriate wait, continuity, cancellation, escalation, patient experience, workforce load and contribution. Any productivity intervention needs a balancing clinical measure and an explicit stop condition.

The leader must restore confidence during transition. Site executives, clinicians and partners need to know which current decisions stand and which will be revisited. The outgoing leader's knowledge should be captured, but the successor is expected to test inherited explanations against cases and data. Familiarity cannot override evidence.

What you will own

• Regional performance, leadership and operating rhythm.
• Capacity, referral and patient-transfer architecture.
• Site accountabilities and intervention decisions.
• Workforce establishment and cross-site capability deployment.
• Capital, asset utilisation and access investment.
• Payer, community and delivery-partner coordination.
• Quality-balanced productivity and service economics.
• Regional succession and leadership depth.

The first 12 months

Within 30 days, validate priority queues, visit every major site and identify capacity that is unavailable for a controllable reason. Put immediate ownership around patients lacking a confirmed next step.

By month five, operate common regional referral rules, establish capability-based workforce deployment and decide the contested capital cases. Replace site-only performance reviews with constraint-based regional management.

At twelve months, reduce the 90th-percentile wait in priority pathways by 35%, increase usable capacity from current assets by 15% and cut late cancellations by 25%. At least 95% of transferred patients should have confirmed receiving ownership, premium labour should fall by 20%, and no priority queue should remain unvalidated for more than seven days.

What the board will examine

• Capacity measured as deliverable pathways, not empty rooms.
• Patients moved without losing ownership or information.
• Site leaders acting for regional outcomes.
• Workforce mobility supported by competence and orientation.
• Access mitigations included in consolidation decisions.
• Productivity gains retaining clinical and workforce balance.

The person

You bring 28+ years in healthcare delivery and recent regional, country or multi-site P&L leadership. Your record includes access redesign across several clinical sites, major workforce and capital authority, and direct accountability to a board or governing committee in the United States.

The board seeks evidence that you redistributed demand and capability across organisational boundaries while maintaining local trust. You can challenge medical and site leaders respectfully, make an unpopular asset choice and explain patient consequences clearly. The permanent role is onsite in Boston with frequent travel across the region.

Compensation and terms

Base compensation is USD 500,000–750,000 plus annual incentive and long-term participation linked to safe access, capacity release, regional contribution, workforce stability and succession. The permanent appointment is onsite in Boston, reporting to the Group board and Group Chief Executive. Replacement proceeds urgently, with a controlled transition expected.

Confidentiality

The network, sites, clinicians, patients, payers, partners, capacity data and transition circumstances are confidential. Further detail follows conflict review and signed confidentiality. Candidates must not approach healthcare providers or regional clinicians to identify the organisation.