Director of Nursing (RN) - Home Health

Job Description

Job DescriptionThis family owned is seeking an experienced Director of Nursing (RN) to lead clinical operations in our Medicare-certified home health agency in San Antonio.

We are looking for a DON who is strong in clinical oversight, compliance, OASIS integrity, staff accountability, and survey readiness — someone who can lead with structure, support the team, and help us continue to grow responsibly.

This is a leadership role, not a “do everything alone” role. We already have office support in place, including QA and intake staff. We need a DON who can provide high-level clinical leadership, build consistency, and keep the agency audit-ready.

What You’ll Be Responsible For

• Oversight of day-to-day clinical operations in a Medicare-certified home health setting
  
  
• Ensuring documentation is accurate, timely, and audit-ready
  
  
• Clinical oversight of OASIS, with focus on high-risk, unusual, or repeat-error cases
  
  
• Supporting QA processes and identifying patterns that need correction or retraining
  
  
• Training, coaching, and holding RNs/LVNs accountable to agency standards
  
  
• Maintaining survey readiness, infection control tracking, and general clinical compliance
  
  
• Overseeing physician orders, plan of care follow-up, and clinical escalations
  
  
• Participating in QAPI / performance improvement processes
  
  
• Supporting staff development while maintaining clear standards and expectations
  
  
• Working closely with office staff, QA, intake, and field clinicians to keep operations smooth
  
  
• Providing limited field support for true coverage gaps, high-risk visits, or urgent clinical needs when necessary
  
  

What We’re Looking For

• Active Texas RN license
  
  
• Prior experience in home health leadership, preferably as a DON, Clinical Supervisor, or Clinical Director
  
  
• Strong knowledge of Medicare home health regulations, Conditions of Participation, and clinical documentation standards
  
  
• Strong understanding of OASIS, QA, audit readiness, physician orders, and compliance workflows
  
  
• Experience with staff training, competency development, and accountability
  
  
• Ability to identify problems early and address them calmly and professionally
  
  
• Comfortable leading an office-based clinical team while also supporting field clinicians
  
  
• Able to work with structure, delegate effectively, and avoid becoming the bottleneck
  
  
• Experience with Axxess or similar EMR strongly preferred
  
  

The Right Fit for This Role

The right candidate is:

• organized
  
  
• steady
  
  
• clinically strong
  
  
• comfortable making decisions
  
  
• not afraid to hold standards
  
  
• able to train staff without taking all the work back
  
  
• willing to lead from the office while stepping in when truly needed
  
  

We are looking for someone who wants to build something long-term and help the agency grow responsibly, not someone looking for a short-term stop.

What We Offer

• Full-time salaried position
  
  
• Competitive salary based on experience
  
  
• Stable office support structure
  
  
• Opportunity to help shape clinical systems and growth
  
  
• Supportive environment with leadership that values compliance, documentation, and doing things the right way
  
  

If you are a strong home health RN leader who values structure, accountability, and quality care, we would love to hear from you.

Apply with resume.