Clinical & Residential Services Director

Key Responsibilities

and Duties Statewide Residential & Clinical Leadership (Rule 115/116 Integration) Provide statewide leadership and oversight of residential and clinical services to ensure consistent, compliant, and person-centered support. Ensure Rule 115 residential standards and Rule 116 clinical/nursing standards are fully integrated into daily program operations.

Support Area Managers, Residential Managers, and Team Leads in managing complex residential, medical, and behavioral situations. Establish statewide expectations for service delivery, documentation, staffing patterns, and home operations. Rule 115 Application Oversight & Leadership Structure Accountability Serve as the statewide authority for Rule 115 interpretation, implementation, and enforcement across all programs.

Define, train, and monitor the specific Rule 115 responsibilities of each leadership role, ensuring consistent application statewide. Area Managers Ensure weekly home visits and operational oversight of assigned homes are completed and documented. Monitor implementation plans, staffing, medical follow-through, and daily service delivery for Rule 115 compliance.

Verify house documentation systems (drills, logs, incident reporting, shift notes, etc.) are maintained accurately and on schedule. Provide coaching, corrective direction, and follow-up to Managers and DSPs tied to Rule 115 findings. Residential Managers Oversee multi-home program compliance, audits, and individualized file accuracy.

Ensure quarterly case file reviews, implementation plan updates, and support team participation meet Rule 115 expectations. Track Medicaid-waiver documentation standards and ensure required submissions are timely and complete. Coordinate with Area Managers to address systemic compliance gaps and service concerns. Team Leads Maintain daily Rule 115 compliance at the home level including staffing coverage, documentation completion, and implementation of resident supports.

Ensure all house binders, logs, and resident files are updated, organized, and audit-ready. Supervise DSP performance and ensure person-centered supports are delivered consistently. Ensure leadership teams use standardized tracking tools for Rule 115 compliance and performance monitoring. Hold leaders accountable for completion of corrective actions tied to Rule 115 audits, incident trends, and DHS-DDD correspondence.

Lead statewide Rule 115 refresher training and competency checks for all supervisory roles. Rule 115 Compliance & Residential Program Oversight Ensure statewide compliance with Rule 115 , Medicaid Waiver requirements, and DHS-DDD directives. Oversee systems for development, implementation, and monitoring of individual implementation plans and service outcomes.

Ensure support team meeting participation and follow-through on identified resident risks, goals, and service modifications. Ensure quarterly and annual residential audits are completed and corrective actions implemented. Coordinate with QA/Compliance to review monthly random client file reviews for Rule 115 and ensure timely corrections and retraining for staff.

Monitor incident trends, environmental safety issues, and program risks; develop statewide mitigation plans. House Documentation & Operational Standards Ensure oversight for all homes maintaining complete, accurate, and current house documentation, including: Fire, tornado, evacuation, and other emergency drills Water temperature logs Refrigerator/freezer temperature logs Medication Count Sheets and MAR/TAR alignment (with nursing oversight) Shift notes, progress notes, and incident documentation Vehicle logs and safety checks (if applicable) Create, standardize, and update statewide templates and tracking tools to improve documentation quality and consistency.

Train residential leaders on documentation timelines, standards, and compliance expectations. Clinical Services & Rule 116 Oversight Provide clinical direction and oversight to nursing staff and clinical contractors statewide. Ensure statewide compliance with Rule 116 and clinical Medicaid Waiver requirements. Oversee clinical documentation systems (health summaries, nursing notes, physician orders, medication reviews, treatment plans).

Partner with QA/Compliance to review monthly random clinical file reviews for Rule 116 and drive corrective follow-up with staff. Review clinical incidents, medication errors, adverse events, and hospitalizations; implement systemic improvements. Medical Coordination & Appointment Management Oversee statewide systems for scheduling, tracking, and follow-through on routine, specialty, and emergency medical appointments.

Personally transport and/or accompany individuals to appointments when needed for continuity, advocacy, or crisis support. Ensure visit results, physician orders, and recommendations are communicated to teams and implemented accurately. Coordinate transitions of care after hospitalizations or major medical events. Benefits, Medicaid & Social Security Coordination Ensure statewide completion and tracking of Medicaid redeterminations , including timelines, paperwork accuracy, and documentation storage.

Oversee coordination of Social Security appointments and benefit setup , renewals, representative payee needs, and follow-through. Audit eligibility systems to prevent gaps in benefits and ensure uninterrupted funding/support. Collaborate with guardians, ISC/case managers, and funding entities statewide regarding eligibility issues.

Staff Supervision, Development & Workforce Systems Provide supervision, coaching, and performance oversight for residential and nursing leadership staff (direct reports may include Area Managers, Residential Managers, Nurses, or Case Managers. Ensure recruitment, onboarding, and retention systems support high-quality residential and clinical services.

Oversee statewide staff compliance systems, including: Staff folders Annual background checks DSP Registry enrollment/updates Mandated training completion Quality Improvement, Corrective Action & Licensing Readiness Lead statewide continuous quality improvement based on audits, trend data, incidents, and resident outcomes.

Ensure all programs remain survey-ready and support preparation for licensing visits, Medicaid Waiver reviews, and compliance investigations. Produce statewide performance and compliance reports for executive leadership. External & Community Liaison Serve as a statewide liaison to families/guardians, contracted providers, medical systems, and DHS-DDD regarding residential or clinical concerns.

Participate in external meetings, state trainings, and regulatory updates; disseminate changes to teams and update policy accordingly. Strengthen community partnerships that enhance resident health, safety, inclusion, and outcomes.

Qualifications

Bachelor’s Degree in Human Services, Social Work, Business Administration, or a related field. Advanced degree a plus. Minimum 5 years experience in clinical/nursing and/or residential services for individuals with developmental disabilities, including 2–3 years in leadership. Strong working knowledge of Rule 115, Rule 116, Medicaid Waiver requirements, and DHS-DDD standards.

Demonstrated experience overseeing multi-site programs, audits, staff development, and compliance systems. High competence in documentation review, risk management, corrective action planning, and continuous improvement. Excellent organizational, analytical, training, and communication skills. Ability to travel statewide routinely and respond to urgent program or clinical needs.

Proficiency in Google Suite and electronic documentation/clinical systems. Valid driver’s license and reliable transportation. Must pass required background checks and regulatory screenings. Core Competencies Integrated residential + clinical leadership Rule 115/116 regulatory expertise and practical application Multi-site program management Documentation and audit readiness Medical and benefits coordination Staff coaching, training, and accountability Risk mitigation and crisis response Data-driven quality improvement Strong stakeholder communication Salary $80,000 - $90,000 per year