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Job Summary:
The Clinical Operations Leader is responsible for the strategic oversight and clinical operations of in-home nursing and cluster home care services across the New York market. This role ensures compliance with New York State Department of Health (DOH) regulations, Managed Long-Term Care (MLTC) program requirements, and Federal guidelines. The Clinical Leader supports a growing client base exceeding 5,000 individuals and leads a multidisciplinary clinical team to deliver high-quality, cost-effective, and person-centered care in community settings. Key responsibilities include planning, directing, and evaluating clinical initiatives to ensure optimal service delivery, quality, and regulatory compliance.
Regular onsite presence required in the Industry City office with occasional visits to offices across all five boroughs. This person must reside in the NYC area.
Essential Duties and Responsibilities: Lead execution of clinical business operations for in-home nursing and cluster home care models specific to NY State requirements. Ensure compliance with DOH regulations, MLTC guidelines, and Medicaid contractual obligations. Oversee all aspects of client care including admission assessments, reassessments, supervision, and case management services to maintain compliance with productivity standards. Collaborate with Operations, Intake, and Quality & Compliance teams to develop, review, and implement clinical protocols tailored to the needs of high-volume home care populations. Monitor service delivery outcomes, KPIs, and care quality benchmarks across a client base of 5,000+ individuals. Direct strategic deployment of clinical programs to support MLTC plans, home-based skilled services, and caregiver support. Ensure timely clinical documentation, visit compliance, and execution of nurse visit schedules, including urgent and high-risk cases. Lead efforts in continuous improvement, incorporating best practices, data analytics, and clinical technology enhancements. Maintain a proactive approach to workforce planning, nurse recruitment, and retention to ensure appropriate staffing for large-scale client needs. Track and ensure timely completion of mandatory trainings, CEUs, and licensure renewals for all clinical staff. Collaborate with Quality and Compliance to support audit readiness, implement corrective action plans, and improve clinical documentation processes. Serve as a senior clinical liaison with MLTC health plans, state surveyors, and external stakeholders.
Education and Experience: Bachelor of Science in Nursing (BSN) required;
Master’s in Nursing, Healthcare Administration, or Business Administration (MBA) preferred . Current NYS Registered Nurse (RN) license in good standing. Minimum 5 years of progressive leadership in home health or home care operations, with significant experience in New York's MLTC and Medicaid landscape. Proven experience managing clinical teams serving over 5,000 clients across dispersed home/community-based settings. Deep understanding of NYS DOH regulations, CHHA/LHCSA operations, and MLTC quality measures (e.g., UAS-NY). Minimum of three (3) years of quality/process improvement experience. Advanced skills in Microsoft Office, EMR/EHR systems, and clinical workflow optimization.
Regular onsite presence required in the Industry City office with occasional visits to offices across all five boroughs. This person must reside in the NYC area.
Essential Duties and Responsibilities: Lead execution of clinical business operations for in-home nursing and cluster home care models specific to NY State requirements. Ensure compliance with DOH regulations, MLTC guidelines, and Medicaid contractual obligations. Oversee all aspects of client care including admission assessments, reassessments, supervision, and case management services to maintain compliance with productivity standards. Collaborate with Operations, Intake, and Quality & Compliance teams to develop, review, and implement clinical protocols tailored to the needs of high-volume home care populations. Monitor service delivery outcomes, KPIs, and care quality benchmarks across a client base of 5,000+ individuals. Direct strategic deployment of clinical programs to support MLTC plans, home-based skilled services, and caregiver support. Ensure timely clinical documentation, visit compliance, and execution of nurse visit schedules, including urgent and high-risk cases. Lead efforts in continuous improvement, incorporating best practices, data analytics, and clinical technology enhancements. Maintain a proactive approach to workforce planning, nurse recruitment, and retention to ensure appropriate staffing for large-scale client needs. Track and ensure timely completion of mandatory trainings, CEUs, and licensure renewals for all clinical staff. Collaborate with Quality and Compliance to support audit readiness, implement corrective action plans, and improve clinical documentation processes. Serve as a senior clinical liaison with MLTC health plans, state surveyors, and external stakeholders.
Education and Experience: Bachelor of Science in Nursing (BSN) required;
Master’s in Nursing, Healthcare Administration, or Business Administration (MBA) preferred . Current NYS Registered Nurse (RN) license in good standing. Minimum 5 years of progressive leadership in home health or home care operations, with significant experience in New York's MLTC and Medicaid landscape. Proven experience managing clinical teams serving over 5,000 clients across dispersed home/community-based settings. Deep understanding of NYS DOH regulations, CHHA/LHCSA operations, and MLTC quality measures (e.g., UAS-NY). Minimum of three (3) years of quality/process improvement experience. Advanced skills in Microsoft Office, EMR/EHR systems, and clinical workflow optimization.