Director of Clinical Operations & CMS Compliance

PROMEDIX® HEALTH; Santa Ana (CA); On-site; USD 120,000 - 165,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company match

Life insurance

Job summary

ProMedix Health is seeking a Director of Clinical Operations in Santa Ana, CA to lead nursing and care management teams, governing CMS documentation standards and compliant billing across CCM and RPM programs.

The ideal candidate is an RN with BSN, California license, and 5+ years in clinical operations leadership, proficient in building SOPs, workflows, and training programs in a fast-growing telehealth environment.

Qualifications

• Active RN license in California (BSN required).
• 5+ years in clinical operations or care management leadership.
• Working knowledge of CMS requirements for CCM and RPM and compliant documentation.
• Experience building SOPs, workflows, and documentation standards in a compliance-sensitive environment.
• Familiarity with EHR systems in a care management context.
• Ability to lead and develop a clinical team.

Responsibilities

• Lead nursing staff and care coordinators: supervision, coaching, development.
• Set productivity standards: panel capacity, documentation, patient engagement, alert response times.
• Recruit and onboard clinical staff; build training programs.
• Own CMS compliance across CCM and RPM: documentation, billing, audit readiness.
• Conduct internal audits; identify deficiencies and implement corrections.
• Train clinical teams on documentation for medical necessity and defensible records.
• Work with billing to ensure documentation supports billed services.
• Build and maintain SOPs for clinical workflows: onboarding, monitoring, care plan, escalation, disenrollment.
• Ensure workflows are scalable and compliant across physician partners.
• Manage enrollment-to-clinical handoff and resolve bottlenecks.

Skills

Team leadership

Performance management

CMS familiarity

Clinical operations

Education

RN license in California

BSN degree

Tools

EHR systems

Job description

ProMedix Health is seeking a Director of Clinical Operations in Santa Ana, CA to lead nursing and care management teams, governing CMS documentation standards and compliant billing across CCM and RPM programs.

The ideal candidate is an RN with BSN, California license, and 5+ years in clinical operations leadership, proficient in building SOPs, workflows, and training programs in a fast-growing telehealth environment.