Director of Nursing

We are a growing, non-Medicare-certified home health agency primarily serving children and adults with disabilities through skilled and non-skilled home and community-based services. We are seeking an experienced, dependable, and proactive Registered Nurse (RN) Director of Nursing to lead and strengthen our clinical operations as we continue to grow. Our current census and clinical team structure provides our DON with the opportunity to become genuinely familiar with our clients, their families, field staff, and individual clinical needs while helping us develop the systems and clinical infrastructure needed for continued growth. This is an excellent opportunity for an RN who wants to help strengthen and grow a clinical department rather than simply inherit an established corporate system. Position Summary The Director of Nursing (DON) is responsible for the overall clinical leadership, supervision, quality, coordination, and delivery of nursing services provided by the agency. This is a hands-on working leadership position designed for a growing home health agency with private-duty nursing, skilled nursing, and affiliated community clients. The DON is expected to independently manage day-to-day clinical operations, maintain familiarity with active patients and their care needs, support field staff, perform assessments and supervisory visits when needed, and ensure clinical issues are identified, followed through, and resolved. The successful candidate must be proactive, organized, clinically strong, comfortable working both in the office and field, and capable of taking true ownership of the agency's clinical operations. Reports To Administrator Clinical Leadership & Patient Oversight The DON will: Assume primary responsibility for day-to-day clinical operations. Maintain working knowledge of the agency's active patients, diagnoses, care needs, risks, medications, behavioral considerations, treatment plans, and significant changes in condition. Serve as the primary clinical escalation point for field nurses, caregivers, patients, families, case managers, and other members of the care team. Independently investigate and resolve routine clinical concerns. Determine when matters require escalation to the Administrator, physician, emergency services, payer, or other appropriate entity. Monitor changes in patient condition and ensure appropriate follow-up occurs. Coordinate continuity of care across nursing staff, providers, case managers, families, pharmacies, DME providers, and other members of the care team. Assessments, Plans of Care & Clinical Orders The DON will: Perform or coordinate initial nursing assessments, reassessments, recertifications, resumptions of care, supervisory visits, and discharge assessments as applicable. Complete and/or review Plans of Care and ensure they accurately reflect current patient needs and authorized services. Review clinical referrals and determine whether the agency can safely and appropriately meet the patient's needs. Review available clinical documentation before admission and identify missing information. Obtain and follow up on physician/APRN/PA orders and signatures as applicable. Track expiring Plans of Care, orders, certifications, and other time-sensitive clinical documentation. Ensure ordered visit frequencies and services are consistent with authorizations and the current Plan of Care. Coordinate with the authorization/intake team when additional clinical documentation is required to support initial or continued authorization. Community Setting Clinical Oversight For patients receiving services in affiliated community settings, the DON will: Maintain detailed familiarity with each patient's clinical condition, medications, treatments, behavioral considerations, risks, appointments, and current care needs. Conduct routine clinical rounds and supervisory visits. Review MARs/TARs and other clinical records for completeness and accuracy as applicable. Follow up on abnormal findings, changes in condition, medication concerns, wounds, falls, hospitalizations, emergency-room visits, and other clinical events. Participate in and prepare for MDT meetings and case conferences. Communicate effectively with parents/guardians, physicians, case managers, pharmacies, specialists, and other providers. Ensure clinical recommendations and action items identified during MDTs or appointments are completed and documented. Clinical Quality Assurance The DON will: Conduct routine clinical documentation and chart audits reviewing nursing documentation for completeness, accuracy, timeliness, medical necessity, Plan-of-Care compliance, and consistency with authorized services. Track recurring documentation errors and provide staff education or corrective coaching. Review admission, recertification, resumption-of-care, discharge, supervisory, and other applicable clinical documentation. Work with billing and administrative staff to resolve clinical documentation deficiencies that prevent clean claim submission. Assist in developing systems that reduce claim delays caused by clinical documentation errors. Incident Management & Risk Reduction The DON will: Review and investigate clinical incidents, including medication errors, falls, wounds/skin concerns, injuries, hospitalizations, changes in condition, and other adverse events. Ensure physicians, representatives, case managers, regulators, or other parties have been notified when required. Conduct or participate in root-cause analysis. Develop and monitor corrective actions. Identify trends and recurring risks across patients, homes, and staff. Escalate significant clinical, regulatory, legal, or patient-safety concerns promptly to the Administrator. Nursing Staff Supervision & Competency The DON will: Provide clinical supervision to RNs, LPNs, CNAs/HHAs and other applicable clinical personnel within the agency's organizational structure. Participate in clinical interviews and provide recommendations regarding nursing candidates. Conduct or oversee clinical orientation. Complete competency validation/check-offs appropriate to the employee's assigned duties. Identify nurses who require additional education or remediation. Provide focused clinical education and skills refreshers. Conduct supervisory and performance visits in the field. Partner with HR and the Administrator regarding clinical performance concerns, corrective action, suspension from patient care, or termination recommendations. Ensure nurses are assigned only to patients whose needs are consistent with their demonstrated competency and scope of practice. Intake & Admissions Support The DON will: Provide timely clinical review of incoming referrals. Determine whether the agency has the clinical capability to safely accept a case. Identify required nursing skill level and competencies. Review clinical documentation for appropriateness and completeness. Communicate clinical documentation needs to the Intake/Authorization Coordinator. Assist with complex authorization requests, denials, peer-to-peer preparation, letters of medical necessity, or other clinical justification when appropriate. Participate in admission planning to ensure staffing, orders, supplies, equipment, and clinical needs are addressed before start of care. Staffing & Coverage The DON will: Work collaboratively with the Staffing/Scheduling Coordinator regarding patient acuity, staff competency, skill matching, authorized hours/visits, and clinical coverage concerns. Assist with urgent clinical coverage when necessary to protect patient safety and continuity of care. Participate in the clinical on-call rotation as assigned. Provide clinical direction during urgent staffing situations. QAPI & Regulatory Readiness The DON will: Participate in and help lead clinical components of QAPI. Track clinical trends, incidents, documentation deficiencies, hospitalizations, complaints, infections, wounds, medication errors, and other identified indicators. Develop and monitor clinical performance-improvement initiatives. Assist with AHCA, payer, Medicaid MCO, accreditation, and other applicable reviews. Maintain clinical operations in a survey-ready state. Assist with policy review and implementation as related to nursing and clinical services. Field Expectations This is a working clinical leadership position. Depending on census and operational needs, the DON may: Perform assessments and supervisory visits. Conduct clinical rounds at community residential settings. Provide skilled nursing visits when necessary to support continuity of care. Conduct staff competency observations in the field. Attend patient care conferences when clinically necessary. Key Performance Expectations Success in this position includes: Clinical concerns are followed through as appropriate. Plans of Care, orders, assessments and other required clinical documents are completed on time. Clinical documentation defects decrease. Staff receive timely clinical supervision and coaching. Incidents receive documented follow-up and corrective action. Community residential patients receive proactive clinical oversight. MDT meetings are attended by a clinical leader who understands the patient's current condition and needs. Referral clinical reviews are completed promptly. Clinical components of authorization and reauthorization requests are completed timely. The agency remains survey-ready. Minimum Qualifications Current, unrestricted Florida Registered Nurse license. Graduate of an approved school of nursing. Minimum one year of supervisory experience as a Registered Nurse. A clean level II background screening with AHCA, APD, and DCF Home health, private-duty nursing, community nursing, pediatric, developmental-disability, or facility-based experience strongly preferred. Strong clinical assessment and documentation skills. Familiarity with CMS, AHCA, and ACHC regulations. Demonstrated ability to supervise and coach nursing personnel. Strong organizational and follow-through skills. Comfortable using EMR, scheduling, communication and documentation systems. Reliable transportation Comprehensive Employee Benefits We value the professionals who help us care for our clients and grow our organization. Eligible full-time employees have access to a comprehensive employee benefits package designed to support their health, financial well-being, work-life balance, and professional development. Preferred Candidate Profile The ideal candidate is a working clinical leader, not solely an administrative manager. The candidate should be comfortable moving between clinical leadership, patient assessment, quality assurance, staff supervision, clinical oversight, provider communication and occasional field nursing responsibilities as the needs of a growing agency change. Most importantly, the DON must demonstrate initiative, clinical judgment, accountability and consistent follow-through. As a growing agency, we offer the right DON an opportunity to have a meaningful voice in how our clinical operations develop. You will work closely with the Administrator to strengthen quality systems, improve clinical workflows, develop nursing staff, support expansion of clinical services, and help build programs that grow with the organization. This is a full-time, hourly position with a primary office schedule of approximately 8:30 AM–4:30 PM, Monday through Friday , with rotating on-call schedules, subject to adjustment based on patient care and operational needs. #J-18808-Ljbffr