This leadership role provides strategic direction, operational oversight, and clinical guidance to ensure the delivery of high-quality hospice care across the agency. The Director of Clinical Operations (DCO) is accountable for aligning patient-centered care with regulatory compliance, operational efficiency, financial performance, and staff development. The role suits an experienced Registered Nurse who can oversee clinical and non-clinical teams, optimize staffing models, ensure survey readiness, and drive operational excellence.
Responsibilities
Direct the overall clinical operations of the assigned team(s), ensuring standardization of processes, outcomes, and regulatory compliance, and ensuring all patients receive compassionate, timely, and high-quality care
Supervise and support Registered Nurses (RN), Licensed Practical Nurses/Licensed Vocational Nurses (LPN/LVN), Certified Nursing Assistants (CNA), Social Workers (SW), Chaplains (CH), Team Managers (TM), and Interdisciplinary Group (IDG) members
Ensure consistent implementation of clinical policies, procedures, and evidence-based practices across all teams
Ensure timely hospice admissions by streamlining workflows and partnering with intake and clinical teams to provide rapid access to care, symptom management, and support at the point of need
Partner with Medical Directors and attending physicians to ensure accurate documentation, timely certifications, and effective symptom management
Lead and facilitate IDG meetings, ensuring timely updates, thorough eligibility review, and seamless care coordination
Lead or participate in Quality Assurance Performance Improvement (QAPI) programs and Performance Improvement Projects (PIPs)
Audit clinical documentation for accuracy, completeness, and compliance, addressing deficiencies promptly in collaboration with Compliance
Promote effective collaboration among physicians, nurses, social workers, facility partners, and internal departments to ensure coordinated, patient-centered care
Ensure appropriate, timely, and safe transitions of care (e.g., level-of-care changes, discharges, transfers)
Maintain continuous compliance with Medicare Conditions of Participation, state regulations, and accreditation standards
Oversee preparation for regulatory and accreditation surveys to ensure ongoing readiness
Monitor compliance with face-to-face (F2F) visits, hospice eligibility documentation, and timely physician certifications
Track and act on key quality indicators, including CAHPS scores, audit scores, ALOS, HOPE compliance, and clinical record reviews
Lead root cause analyses of clinical deficiencies, survey citations, and patient/family complaints; implement corrective action plans
Drive performance improvement initiatives focused on patient/family satisfaction, clinical quality outcomes, and regulatory adherence
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Partner with the ED, SDCO (if applicable), AVPO, and regional leadership to manage budgets, resource allocation, and productivity standards
Develop and manage staffing models in adherence to company best practices that balance patient care needs, efficiency, and financial goals
Monitor and act on weekly/monthly KPIs, including:
ADC & Growth Metrics: census trends, referral conversions
Utilization Metrics: ALOS, GIP % of days, Continuous Care % of days, HVLDL, NTUCs
Monitor and control labor spend, overtime, and contract labor usage while maintaining company-established staffing ratios and productivity expectations
Implement corrective action plans when KPIs fall below target
Mentor and develop the assigned team(s) to ensure high performance, strong retention, and succession planning
Identify and prepare high-potential team members for future leadership pathways
Ensure structured onboarding, ongoing education, and competency validation for all clinical hires within assigned team(s)
Promote a culture of accountability, collaboration, and professional growth across the team
Conduct regular meetings with direct reports and oversee performance management and staff engagement
Serve as a key liaison between clinical operations, medical leadership, business development, and administrative functions
Foster effective communication across teams to ensure seamless patient care and care coordination
Serve as acting Administrator or Executive Director as needed
Participate in community relations activities to strengthen organizational presence and referrals
Demonstrate urgency and ownership in addressing patient/family concerns, ensuring timely service recovery
Participate in on-call rotation and serve as Administrator On-Call when assigned
Respond promptly to after-hours issues related to patient care or staffing
Perform other duties as assigned
Requirements
Bachelor of Science in Nursing (BSN) required
Current and active Registered Nurse (RN) license
Minimum of 2 years of clinical management or supervisory experience in hospice or home health
Strong knowledge of hospice philosophy, end-of-life care, and pain/symptom management principles
Demonstrated experience in working effectively within an IDG
Proficient in Electronic Medical Records (EMR) systems
Thorough understanding of Medicare, Medicaid, and accrediting body standards (ACHC, CHAP, or Joint Commission)
Knowledge of QAPI programs, compliance audits, and performance improvement initiatives
Ability to lead, coach, and develop clinical teams, fostering accountability and engagement
Strong operational skills, including budget management, cost-per-patient-day oversight, and resource allocation
Ability to analyze operational and clinical data for continuous improvement
Excellent oral and written communication skills, ability to interact effectively with patients, families, staff, and physicians
Strong problem-solving and decision-making abilities in a fast-paced environment
High level of professionalism, emotional intelligence, and customer service orientation
Nice to have:
Master’s degree in nursing, Healthcare Administration, or related field
Homecare Homebase EMR system experience
About the Company
Three Oaks Hospice and its sister companies provide hospice and palliative care. They share a unified mission to deliver best-in-class care to patients and families.
