Hospice Director of Clinical Operations (DCO)

About the Role

The Director of Clinical Operations (DCO) provides strategic leadership, operational oversight, and clinical guidance to ensure the delivery of high-quality hospice care across the agency. This role holds accountability for aligning patient-centered care with regulatory compliance, operational efficiency, financial performance, and staff development. The DCO oversees clinical and non-clinical teams, optimizes staffing models, ensures survey readiness, and drives operational excellence. Partnering closely with leadership, the DCO ensures clinical operations meet or exceed quality, compliance, and growth goals while fostering leadership development and a culture of accountability.

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.
• Partner with leadership to manage budgets, resource allocation, and productivity standards. Develop and manage staffing models 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
  • Staffing & Productivity Metrics: caseload ratios, visit productivity, cost per patient day, labor ratios
  • Quality Metrics: CAHPS, survey/audit scores, HOPE compliance
• 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.

Qualifications

• Bachelor of Science in Nursing (BSN) required. Master’s degree in nursing, Healthcare Administration, or related field preferred.
• 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. Homecare Homebase strongly preferred.
• Thorough understanding of Medicare, Medicaid, and accrediting body standards (ACHC, CHAP, or Joint Commission).
• Knowledge of QAPI programs, compliance audits, and performance improvement initiatives.

Skills

• 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.

Why Work For Us

We are committed to being an employer of choice, offering a supportive culture centered on patient care, clinical excellence, and employee success. If you’re looking for purpose, stability, and growth—this is the place to be. As part of our connected network of hospice and palliative care organizations, you’ll work alongside compassionate professionals dedicated to delivering best-in-class care to patients and families.