Director Clinical Operations

Director of Clinical OperationsAbout Gracey Care Gracey Care helps aging adults stay safely at home and supports the families who look after them. Each patient has one assigned care manager, telehealth visits with a nurse practitioner, and a care plan that a licensed clinician approves. AI agents handle the paperwork around the care, like intake, eligibility, scheduling, record retrieval and documentation checks, so our people can spend their time with patients and families. Many families find us through their employer’s EAP benefit. Our care team is remote and serves Medicare patients across the country. The role Over the next 18 months we’re growing from our first patient cohorts to thousands of patients. We’ll only grow as fast as quality allows. A new cohort opens only after safety, staffing, documentation and billing quality pass a defined gate. You’ll own the operating system behind those gates: the SOPs, the scorecard, the audit calendar, and the care-manager team that does the work. You’ll report to the COO and work closely with the Medical Director, who owns clinical standards. Licensed clinicians keep every clinical decision. Your job is to make sure the work around those decisions happens on time, every time, and that we can prove it. This is a hands-on job. You’ll manage the care-manager team directly. As the team grows you’ll hire team leads, and later a Head of Care Management. What you’ll own The care-manager team. You’ll run recruiting and onboarding for care managers, working with our scored screening process. You’ll make sure OIG exclusion checks, background checks and drug screens are done before anyone starts. No one manages patients on their own until they’ve passed the competency sign-off. You’ll keep track of availability, workload, time off and backup, so that no patient depends on one person. You’ll set performance expectations and coach on what chart reviews find. Time and pay for the team. You’ll own the timesheet approval workflow for our contractor care managers and coordinate payroll with finance. When a pay issue comes up, you fix it quickly. The task queue. Agents create tasks from call transcripts, HIE data and partner care packets. Each task gets an owner, a due date and a priority, and overdue items escalate automatically. You set the SLAs and make sure the team meets them. The operating scorecard. Every metric has a numerator, denominator, data source, owner and escalation threshold. Examples: initial NP evaluation within 14 days of enrollment, care plan clinically reviewed within 7 days, documentation done within 24 hours, claims clean on first submission, family inquiries acknowledged within one business day, and contact within 48 hours of a hospital discharge alert. Agents compute it daily from athena, Spruce and our HIE feed. You act on it and present it to leadership every month. SOPs for every step of care. This covers enrollment and consent, initial evaluation, care-plan approval, routine outreach, referral follow-through, medication follow-up, escalation, hospital transitions, complaints and discharge. Each process has a named owner and a backup. Audits and safety. You’ll run the audit calendar: monthly chart and claims reviews and a quarterly Quality Assurance Committee. Every incident and near-miss gets tracked to a corrective action. Serious safety events are reviewed within 24 hours. Expansion gates. Before each cohort opens, you bring the evidence. That means no open high-severity safety or compliance issues, staffing capacity shown from observed workload, scorecard metrics at threshold for two periods in a row, downtime procedures tested, and agent error rates within limits. The Medical Director co-signs every go/no-go decision. Clinical leadership can pause enrollment at any time. Capacity planning. Each month you’ll forecast NP and care-manager hours from measured time per patient, acuity, PTO, training and non-patient work. You’ll flag shortfalls 60 days out so that hiring and credentialing stay ahead of demand. You’ll work with our credentialing coordinator on licensure and payer-enrollment dependencies. The line between people and agents. People deliver and log all billable care. Agents do non-billable work and never create billable time. You’ll keep the agent registry (purpose, human owner, data access, checkpoint, error rate, manual fallback) and test new agent workflows before they go live. When clinicians correct AI output, you’ll turn those corrections into SOP and training updates. Partner handoffs. For patients we serve with an external clinical partner, you own the handoff. That includes what we send before the visit, what comes back after, and how escalations route. Billing integrity, with revenue cycle. This means a separate care plan and time log for each program, documented consent, clinician review before billing, and claim scrubbing before submission. Your first 90 days Day 30: you know every care manager’s panel, hours and backup. Every scorecard metric is baselined from real data. Day 60: approved SOP set, escalation matrix, audit calendar and agent registry published. Task-queue SLAs are live. Day 90: a pilot cohort run on the standardized workflow, with a documented go/no-go decision. A hiring plan for the next cohort’s care managers is ready. What you bring 5+ years in healthcare operations (care management, telehealth, home health, primary care or value-based care), including 2+ years directly managing frontline care teams. You’ve built SOPs and a scorecard from scratch and used them to make a real stop-or-go call. You’ve hired, onboarded and managed distributed contractor teams across many states, including scheduling, coverage, timesheets and payroll coordination. You know Medicare documentation and billing rules well enough to spot a time-log or consent gap in a chart. CCM or PIN experience is a plus. You can turn a frontline problem into a clear requirement for engineers, then test the fix yourself. Working knowledge of HIPAA, OIG exclusion screening and incident reporting. Experience with older adults, chronic conditions or family caregivers is a strong plus. An RN or NP license helps but isn’t required. A degree in healthcare administration, business, nursing or public health, or equivalent experience.