Director of Clinical Operations

We are a growing pediatric therapy practice in Raleigh built on a straightforward belief: exceptional clinical outcomes and a strong operational engine are interdependent. This role will carry a small caseload, run the clinical team, and own the scheduling, pipeline, and metrics that keep the practice healthy and growing.

This is a high-ownership role. At its core, it exists to make sure more kids get the right care, from clinicians who are well-led and well-supported. You'll hold your own caseload to stay credible and sharp on clinical judgment, supervise and develop the clinical team, and also own the operational dashboard - scheduling, referral pipeline, staffing, and the numbers that connect all of it. The right person doesn't wait for a playbook, and doesn't need a problem handed to them pre-defined. They find it, work through it, and fix it - clinically and operationally.

What You'll Own:

Clinical Leadership & Caseload:
- Carry your own caseload - staying close to direct care keeps your clinical judgment sharp as well as allowing us to prepare the caseload for the next BCBA hire.
- Supervise and develop BCBAs and clinical staff
- Ensure every client is receiving the treatment plan they need, and that families waiting for services can start as soon as possible.

Operational Leadership & Scheduling:
- Serve as the operational anchor of the practice -understanding how everything connects and troubleshooting across departments without needing a roadmap.
- Own staff scheduling end-to-end: optimize utilization, minimize coverage gaps, and align clinical capacity with client demand.
- Own the client growth pipeline - manage the BD personnel, track conversion from referral through intake to first session, and pace new client volume to what the clinical team can actually absorb. Velocity matters.
- Manage escalations across facilities, staffing, and logistics, resolving issues quickly and thoroughly.

Process Improvement:
- Act as the translator between clinical work and operations - understanding how scheduling, care delivery, and business performance intersect, and designing solutions that work across all three.
- Drive adoption of improved processes through clear communication, training, and accountability - not just documentation.

KPIs & Accountability:
- Own one dashboard spanning both sides of the practice: hours delivered, authorized vs. delivered hour conversion, treatment plan adherence, new client start timelines, staff utilization, attendance and cancellation rates, and care coordination completion.
- Treat hours delivered as the central metric and understand every lever that moves it - scheduling fill, attendance, clinician conformance, referral conversion.
- Identify trends proactively, diagnose root causes, and bring recommendations - not just reports.
- Hold clinical and operational staff accountable to targets through structured, direct, and respectful follow-through.

Culture & Team Performance:
- Model and reinforce a culture of high standards, ownership, and accountability at every level, across both the clinical and operational sides of the practice.
- Lead team meetings, performance check-ins, and alignment sessions that drive action, not just discussion.
Build trust as someone who is direct, fair, and genuinely invested in the team's success - clinicians and operations staff alike.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to View email address on click.appcast.io learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:


Required Skills & Experience
- Board-Certified Behavior Analyst (BCBA) with 5+ years of experience, including some supervisory or leadership experience.
- Comfortable owning operational and business metrics, not just clinical ones - you think in terms of both client outcomes and practice performance.
- Self-directed: you identify problems, form your own point of view, and move forward with confidence - you don't need someone to define the problem for you.
- Strong work ethic - we are a startup and this role will be demanding
- Analytically strong: you use data to understand problems, make decisions, and measure outcomes, not just to report.
- Track record of holding a team accountable to standards in a direct, respectful, and effective way.
- Strong communicator, equally credible with clinical staff, operations, and executive leadership.
- Five days a week on-site - this role is built around being present, for both the clinical team and the business.


Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.