Director of Real Estate

Position Summary

The Director of Real Estate owns every step from market selection to signed lease, and the lease portfolio thereafter. We open roughly 20 clinics a year today and intend to reach 30. Site selection, LOI and lease negotiation currently run out of the VP of Business Development's desk, and that is the constraint on getting there.

This is a builder's role in a lean organization. You will be the first dedicated real estate hire, you will work directly with the CEO, the VP of Business Development and the Board, and you will set how this function operates rather than inherit a playbook. You will partner closely with the Director of Clinic Development & Facilities, who takes each site from lease signature through construction and opening.

This role has no initial direct reports. You will work through an external broker network and alongside internal project management, legal and finance.

Key Opportunities

•     Own a function outright and define how it runs
•     Report up to the VP of Business Development
•     Set the pace of a national expansion moving from 20 to 30 clinics a year
•     Build the site criteria and the market model the company will use for years
•     Lean organization with opportunity to take on significant responsibility quickly

Responsibilities

New markets and densification

•     Analyze and rank new metro opportunities using demographics, payer landscape, competitive density and labor supply; recommend where we go next and defend it to leadership and the Board
•     Assess densification in markets we already serve — where a second or third clinic adds revenue/ebitda rather than splitting the ones we have
•     Build and maintain the scoring model and site criteria behind those recommendations

Site selection and transactions

•     Source and virtually tour sites, manage the broker network, and maintain a pipeline deep enough to sustain 30 openings a year
•     Negotiate letters of intent
•     Negotiate leases and the documents that go with them: commencement terms, tenant improvement reimbursement, move-in allowance, options and renewal rights
•     Hand each signed site to Clinic Development with the delivery condition, TI allowance and landlord obligations documented

Portfolio and asset management

•     Own the lease portfolio: the critical-date calendar, option notice deadlines, renewals, estoppels and CAM reconciliation
•     Analyze the current clinic footprint — square footage against clinic productivity — and recommend where to expand, contract, sublease or relocate
•     Lead exits: lease termination, assignment and subleasing when a site closes or moves

Partnership

•     Work with Recruiting so market selection matches physician supply; a site we cannot staff is a site we should not sign
•     Work with Revenue Cycle on payer access in a prospective market before we commit to it
•     Report pipeline, cycle times and lease economics to leadership and the Board

Required Skills & Qualifications

•     Bachelor's degree
•     5 to 7+ years in commercial real estate, with direct ownership of site selection and lease negotiation for a multi-site operator
•     A track record of closing sites at volume, you have personally run a pipeline of 15+ locations a year, not supported one
•     Fluent in lease economics: TI allowances, base rent and escalations, CAM, options, delivery condition, landlord work letters
•     Strong analytical skills; you build the market model yourself rather than commission it
•     Excellent written and verbal communication; able to put a site recommendation in front of a CEO and a Board and defend it
•     Demonstrated proficiency with AI tools. You use large language models and AI-assisted tooling as part of your day-to-day workflow, and you can show us how. We will ask you to walk us through real examples: how you prompt, where you have automated or accelerated your own work, and how you check and validate AI output before relying on it.
•     Comfortable operating without a team, you work through brokers, counsel and internal partners
•     Willing to travel to tour markets and sites
•     Applicants must be authorized to work in the U.S.

Nice to Have

None of the following are required. Tell us which ones you have, or which you would be most excited to learn.

•     Healthcare real estate, or another regulated multi-site operator (dental, veterinary, urgent care, dialysis, physical therapy)
•     Experience standing up a real estate function rather than joining an established one
•     Tenant representation background, or time on the brokerage side
•     GIS, site-scoring or trade-area tools — Buxton, Placer.ai, Esri, CoStar
•     Experience with a national tenant-rep relationship at scale

Compensation & Benefits

•     $130k to $190k (based on experience) plus 15% yearly performance bonus
•     Comprehensive benefits package
•     Flexible paid time off
•     401K

Compensation for this role varies based on years of experience, skill set, and alignment with position requirements.

Hiring Process

The hiring process consists of three rounds:

1.     Phone screening interview
2.     Formal hour-long interview
3.     Case study: assess a prospective market and a specific site, and present the recommendation

You are welcome to use AI tools during the case study. We will ask you to show your work and explain your reasoning, including where you used AI and how you verified the results.