Director of Nursing - Pediatric EPSDT program

Description

EPSDT stands for Early and Periodic Screening, Diagnostic, and Treatment. At Inteli-Care, we are proud to support families by providing services that fall under EPSDT, including preventive care, screenings, and treatments designed to identify needs early and support the long-term wellness of Medicaid-eligible individuals under 21 years of age.

We are looking for an experienced, compassionate, and highly organized EPSDT Program Director of Nursing to provide clinical leadership and operational oversight for our EPSDT program.

The EPSDT Program Director of Nursing is responsible for ensuring the delivery of high-quality, compliant, patient-centered nursing services while providing leadership and clinical oversight to the EPSDT nursing team. This position will oversee clinical operations, nursing standards, staff performance, regulatory compliance, care coordination, documentation quality, and program outcomes.

The ideal candidate is a collaborative and accountable nursing leader who combines strong clinical judgment with the ability to develop people, improve processes, and maintain a culture centered on the needs of our Members and their families. You’ll be a perfect fit for our team if you are a caring and compassionate leader, take a patient-first approach, value collaborative and mission-driven work, and are committed to maintaining the highest standards of clinical quality and regulatory compliance.

Responsibilities

Clinical Leadership & Program Oversight

• •Provide overall clinical leadership and nursing oversight for the Inteli-Care EPSDT program.
• •Establish, implement, and maintain nursing standards, clinical procedures, and best practices consistent with EPSDT program requirements and organizational policies.
• •Ensure EPSDT Members receive appropriate, timely, and patient-centered nursing services.
• •Provide clinical consultation and support to EPSDT Registered Nurses and other team members regarding Member needs, changes in condition, plans of care, and complex non-medical situations.
• •Serve as a clinical escalation resource for EPSDT nursing staff.
• •Promote consistent standards of care across all designated EPSDT service areas.
• •Partner with operational leadership to ensure appropriate nursing coverage, caseload management, and continuity of services.
• •Identify opportunities to strengthen clinical processes, improve Member outcomes, and enhance the overall quality of the EPSDT program.

EPSDT Assessments & Member Care

• •Ensure initial and supervisory nursing assessments are completed appropriately to identify the needs of EPSDT Members.
• •Conduct or support initial, supervisory, or other nursing assessments when operationally necessary.
• •Ensure applicable non-medical observations are appropriately documented during Member visits.
• •Ensure required EPSDT visits are conducted and documented every 62 calendar days following the initial assessment, or more frequently when the condition of the Medical Assistance Division eligible recipient warrants additional oversight.
• •Ensure nursing visits conducted at the Member’s residence appropriately assess the Member’s progress and the performance of the Personal Care Services attendant.
• •Oversee the development, clinical review, and ongoing updating of the Individual Treatment Plan (ITP) in collaboration with the Member, family, nursing staff, and Managed Care Organization Care Coordinator.
• •Ensure changes in Member condition, service needs, or risks are identified, communicated, documented, and addressed in a timely manner.
• •Promote continuity of care and appropriate clinical follow-up for EPSDT Members.

Nursing Staff Leadership & Development

• •Provide direct supervision, coaching, development, and performance management for EPSDT nursing staff.
• •Participate in the recruitment, interviewing, selection, onboarding, and retention of qualified EPSDT nurses.
• •Ensure newly hired nursing staff receive appropriate clinical orientation and training before independently performing assigned responsibilities.
• •Assess nursing competencies and provide education, coaching, or corrective action when performance or compliance concerns are identified.
• •Conduct regular team meetings, individual coaching sessions, and clinical case reviews as appropriate.
• •Foster a supportive, accountable, collaborative, and patient-first nursing culture.
• •Ensure nursing staff maintain all required licenses, certifications, credentials, training, and employment requirements.
• •Identify educational needs and coordinate ongoing clinical education and professional development opportunities for nursing staff.
• •Maintain appropriate nursing coverage and assist with contingency planning for staffing changes or Member needs.

Documentation & Regulatory Compliance

• •Ensure all electronic and/or paper clinical documentation is completed accurately, timely, and in accordance with applicable requirements and the designated system of record.
• •Monitor nursing documentation for completeness, accuracy, clinical quality, and compliance.
• •Conduct routine documentation audits and implement corrective action plans when deficiencies or trends are identified.
• •Ensure required EPSDT assessments, supervisory visits, ITP documentation, Member records, and nursing notes are completed within established timelines.
• •Maintain familiarity with applicable EPSDT, Medicaid, Medical Assistance Division, Managed Care Organization, state, federal, and organizational requirements affecting program operations.
• •Translate regulatory and payer requirements into clear nursing processes and staff expectations.
• •Support organizational readiness for audits, reviews, surveys, or regulatory inquiries related to EPSDT nursing services.
• •Participate in the development and ongoing review of clinical policies, procedures, workflows, and forms.
• •Immediately escalate significant clinical, compliance, quality, or safety concerns to appropriate organizational leadership.

Quality Assurance & Performance Improvement

• •Develop and maintain a nursing quality assurance process for the EPSDT program.
• •Monitor key clinical and operational indicators, including required visit completion, documentation timeliness, plan-of-care updates, Member concerns, incidents, and staff performance.
• •Identify trends, gaps, and areas of clinical risk and develop appropriate corrective and preventive actions.
• •Review incidents, complaints, Member concerns, and adverse events involving nursing services and ensure appropriate follow-up.
• •Collaborate with organizational leadership on quality improvement initiatives and program performance goals.
• •Promote evidence-informed non-medical practices and continuous improvement throughout the EPSDT nursing program.
• •Track corrective actions through completion and evaluate their effectiveness.
• •Support initiatives designed to improve Member satisfaction, quality outcomes, and continuity of care.

Care Coordination & Communication

• •Oversee coordination of care between EPSDT nursing staff, Members, families, Personal Care Attendants, Managed Care Organization Care Coordinators, and other prescribed individuals involved in the Member’s care.
• •Maintain effective professional communication with Members, family members, healthcare providers, care coordinators, team members, and other healthcare professionals.
• •Facilitate resolution of clinical or service-related concerns that require nursing leadership involvement.
• •Support nursing staff in obtaining necessary non-medical information, provider orders, Individual Treatment Plan updates, or other information needed to safely coordinate Member services.
• •Build collaborative relationships with internal departments and external healthcare partners.
• •Represent the nursing function in interdisciplinary meetings, leadership discussions, and EPSDT program planning.

Member & Employee Orientation

Oversee nursing responsibilities related to New Employee Orientation (NEO) and N