Regional Manager at Tailwater LLC – Nashville, Tennessee

Tailwater Dental Partners is seeking a Regional Manager located in Nashville, TN to join our growing team!

The Regional Manager (RM) is a senior operating and building leader responsible for the performance, stability, and long-term scalability of a defined portfolio of dental practices.

This role blends hands-on operational ownership with system-building leadership. The RM is accountable for today’s results (revenue, EBITDA, labor efficiency, and operating discipline) while simultaneously building the people, routines, and infrastructure required to support future growth, acquisitions, and scale.

This role requires frequent regional travel, as the RM maintains a visible, on-site presence across assigned practices.

The RM is expected to think like an owner, act like a coach, and build like a founder, driving results now while leaving the region stronger, more consistent, and more scalable than they found it.

Why This Role Matters

As Tailwater grows, execution at the regional level is the difference between growth that compounds and growth that breaks.

The Regional Manager is the connective tissue between strategy and reality, translating enterprise priorities into consistent execution at the practice level, while shaping how the operating model evolves over time.

• Scaling without margin erosion
• Integrating new practices without cultural drift
• Developing leaders who can run independently
• Turning industry best practices into standard practices across the region

The RM does not simply “manage a region”. They build a durable operating system that enables growth, accountability, and excellent patient care.

Core Accountabilities

Regional Financial Performance (Primary Ownership)

• Own full regional P&L, including revenue, EBITDA, labor, and controllable costs
• Deliver regional revenue at or above budget
• Achieve 100% regional EBITDA targets and margin improvement year-over-year
• Proactively identify performance risks and implement corrective action plans

Practice-Level EBITDA Execution

• Ensure =75% of practices meet or exceed EBITDA targets (100% of EBITDA target is met across the region).
• Drive disciplined labor management (target =53% of collections)
• Maintain COGS (lab / supply) spend within approved targets
• Lead structured turnaround plans for underperforming practices with clear milestones and accountability.

Organic Growth & Operational Excellence

• Deliver =5% same-practice organic revenue growth across the region
• Expand access to care through:
• Scheduling efficiency
• Provider utilization
• Case acceptance and treatment flow
• Identify capacity constraints and help design scalable solutions (staffing models, scheduling templates, workflows) rather than one-off fixes.

Revenue Cycle & Cash Discipline

• Ensure net collecti99% across the region
• Partner with practice teams and central RCM to eliminate leakage and breakdowns
• Enforce clean operational handoffs between front office, clinical teams, and billing

M&A Integration & Stability

• Support onboarding and integration of newly acquired practices
• Establish leadership, culture, and operating cadence quickly post-close
• Ensure acquired practices achieve 100% of pro-forma EBITDA within defined timelines
• Reduce post-acquisition volatility by executing and improving repeatable integration playbooks

Leadership, Culture & Talent Development

• Lead, coach, and develop Practice Managers and practice leaders
• Build bench strength and succession depth across the region
• Hold teams accountable through scorecards, weekly priorities, and quarterly reviews
• Serve as a visible champion of organizational values and culture

Scope & Support

• Responsbile for a portfolio of practices (6-9) within a defined geography
• Partners closely with centralized finance, RCM, HR, Recruiting, and IT teams
• Expected to exercise judgment, influence, and leadership, not wait for permission

Success Metrics

The Regional Manager will be evaluated on:

• Revenue vs. Budget
• Regional EBITDA and margin improvement
• Practice EBITDA performance and improvement
• Labor and controllable expense discipline
• Same-practice organic growth
• Net collections performance
• Quality and consistency of operating model
• Leadership development and regional stability

• 7+ years of multi-site operations leadership experience (healthcare or service-based) -
• Demonstrated ownership of P&L and EBITDA outcomes
• Experience leading through both growth and operational complexity
• Proven success leading teams across multiple locations
• Strong analytical, financial, and operational judgment
• Background in dental, medical, or PE-backed environments preferred
• Ability to lead through influence, not just authority
• Comfortable building systems while running the business

Leadership Profile

• Owner-minded, accountable, and results-oriented
• Comfortable operating in ambiguity while building structure
• Strong coach who develops leaders and raises standards
• Bias toward action, consistency, and continuous improvement
• Thrives in high-autonomy, low bureaucracy environment