Position: Clinical Director of Wound Care & CompliancePrimary Responsibilities1. Clinical Policy & Procedure Development
- Develop and maintain all wound care clinical policies and procedures.
- Ensure compliance with Medicare Part B, CMS, LCD/NCD guidelines, and supplier standards.
- Create standardized wound care pathways.
- Develop documentation templates.
- Maintain dressing utilization guidelines.
- Establish dressing selection algorithms.
- Develop infection prevention protocols.
- Create pressure injury prevention protocols.
- Review and update policies quarterly.
2. Clinical Education
Provide ongoing education to:
- SNF nurses
- Wound nurses
- DONs
- Unit Managers
- Therapy staff
- Nurse Practitioners
- Physicians
Training topics include:
- Wound staging
- Skin tear classification
- Moisture-associated skin damage
- Dressing selection
- Frequency of dressing changes
- Documentation requirements
- Medicare coverage requirements
- HCPCS coding basics
- Medical necessity
- Pressure injury prevention
- Product demonstrations
- Best practices
- Infection control
Develop:
- CE presentations
- Monthly webinars
- In-service programs
- Competency testing
- Clinical reference guides
3. Product Selection & Clinical Oversight
Develop evidence-based recommendations for:
- Collagen dressings
- Foam dressings
- Hydrofiber dressings
- Alginate dressings
- Honey dressings
- Hydrogel
- Silver dressings
- Contact layers
- Silicone dressings
- Composite dressings
- Border foams
- Gauze products
- Negative pressure adjuncts
Determine:
- Appropriate product
- When to escalate therapy
- Cost-effective alternatives
- Standard formularies
4. Documentation Review
Review:
- Physician progress notes
- NP documentation
- Nursing documentation
- Weekly wound notes
- Wound measurements
- Supply utilization
- Dressing orders
- Treatment plans
Verify documentation supports:
- Medical necessity
- HCPCS billed
- Dressing quantity
- Frequency
- Stage
- Drainage level
- Tissue type
- Infection status
- Healing progress
Flag deficiencies before claims are submitted.
5. Clinical Compliance
Audit documentation for:
- Medicare requirements
- Supplier standards
- LCD compliance
- Correct ICD-10 coding
- Appropriate HCPCS usage
- Quantity limits
- Dressing frequency
- Medical necessity
- Supporting documentation
Perform internal audits and corrective action plans.
6. Quality Improvement
Monitor:
- Healing rates
- Dressing utilization
- Product outcomes
- Cost per wound
- Infection rates
- Re-admission rates
- Documentation quality
Develop KPI dashboards and quarterly quality reports.
7. IT & Clinical Workflow Development
Work closely with the IT department to design and improve:
Documentation Templates
- Wound intake forms
- Weekly assessments
- Progress notes
- Physician documentation
- Order forms
Clinical Decision Support
Build automated prompts for:
- Dressing recommendations
- HCPCS selection
- ICD-10 suggestions
- Quantity calculations
- Documentation completeness
- Medical necessity alerts
- Compliance warnings
8. AI Clinical Review
Help train AI tools to:
- Read wound notes
- Extract wound measurements
- Identify wound stage
- Recommend dressing categories
- Identify missing documentation
- Flag non-compliant documentation
- Suggest appropriate HCPCS codes
- Suggest supporting ICD-10 codes
- Predict healing trends
9. Product Evaluation
Evaluate new wound care products by:
- Reviewing clinical literature
- Comparing outcomes
- Conducting pilot programs
- Assessing reimbursement
- Performing cost-benefit analyses
- Standardizing approved products
10. Interdisciplinary Collaboration
Partner with:
- Billing Department
- Intake Team
- Clinical Team
- Sales Team
- Customer Service
- Compliance Officer
- Physicians
- Nurse Practitioners
- IT Department
- Executive Leadership
Deliverables
The Clinical Director should develop and maintain:
- Comprehensive Wound Care Policy & Procedure Manual
- Medicare Part B Compliance Manual
- Dressing Selection Guide
- Product Formulary
- HCPCS Crosswalk
- ICD-10 Crosswalk
- Clinical Documentation Guide
- Wound Assessment Handbook
- Nurse Training Program
- Annual Competency Program
- Documentation Audit Tool
- AI Workflow Specifications
- Clinical Dashboard
- Quality Assurance Program
- Monthly Compliance Reports
- Product Evaluation Reports
Ideal Qualifications
- Registered Nurse (RN) with active license (BSN preferred)
- Certification in wound care such as Wound, Ostomy and Continence Nursing Certification Board (WOCN), National Alliance of Wound Care and Ostomy (NAWCO/WCC), or equivalent wound certification
- 5–10+ years of wound care experience in SNFs, long-term care, home health, or hospital settings
- Strong knowledge of Medicare Part B DME and wound dressing coverage
- Experience with EMRs such as PCC and PointClickCare
- Familiarity with HCPCS coding, ICD-10 coding, and documentation standards
- Experience developing clinical policies, training programs, and quality improvement initiatives
- Ability to collaborate with software developers to build clinical decision support and AI-assisted documentation workflows
Pay: $30.00 - $45.00 per hour
Work Location: In person
