Director of Clinical Services

The Director of Clinical Services (DCS) is responsible for the oversight and coordination of clinical operations within the home health agency. This position ensures that all clinical services are delivered in accordance with the latest regulatory guidelines, best practices, and the Patient-Driven Groupings Model (PDGM). The DCS will provide strong leadership to the clinical team and work collaboratively with other departments to ensure efficient, high-quality, and compliant care delivery.

Key Responsibilities

Leadership & Supervision:

• Lead, supervise, and support the clinical team including RNs, LPNs, therapists, aides, and other licensed professionals.
• Facilitate ongoing education, performance evaluations, and staff development.
• Promote a culture of accountability and clinical excellence.

Regulatory Compliance & Quality Assurance:

• Ensure compliance with federal, state, and accrediting body requirements (CMS, Joint Commission, etc.).
• Serve as a point of contact for audits, surveys, and reviews.
• Lead QAPI efforts and clinical performance improvement initiatives.

Clinical Oversight:

• Oversee accurate and timely OASIS documentation aligned with PDGM requirements.
• Review and approve patient assessments, plans of care, and recertifications.
• Ensure care coordination and case management aligns with cost-effective, outcome-driven goals.

PDGM-Specific Responsibilities:

• Expertly manage operations within PDGM to optimize reimbursement while ensuring high-quality care.
• Train clinical staff on PDGM documentation, visit utilization, and LUPA avoidance strategies.
• Monitor admission source, timing, comorbidity adjustments, and functional impairment scoring to ensure proper coding and grouping.
• Work closely with the intake, billing, and coding teams to ensure proper alignment between clinical documentation and reimbursement.

Operational Oversight:

• Collaborate with leadership on staffing plans, caseload management, and productivity expectations.
• Utilize EMR systems to monitor metrics and adjust workflows to meet PDGM and agency performance benchmarks.
• Participate in budget planning, resource allocation, and business growth initiatives.

Qualifications:

• Education: Graduate of an accredited nursing program; BSN preferred.
• Licensure: Active RN license in the state of operation.
• Experience: Minimum of 3-5 years in home health nursing. At least 2 years in a supervisory or clinical leadership role.
• Strong working knowledge of PDGM required.
• Skills:
• Proficient in OASIS, ICD-10 coding, and home health regulations.
• Excellent leadership, organizational, and interpersonal skills.
• Experience with EMR systems (eg, Homecare Homebase, WellSky).
• Proven ability to train and develop clinical staff.

Preferred:

• Certification in home health coding or OASIS (COS-C, HCS-D) a plus.
• Experience leading a Joint Commission or CHAP-accredited agency.

This role requires a dedicated professional who is passionate about delivering exceptional clinical services while leading a team committed to excellence in patient care.