Clinical Compliance Orders Specialist

Care Options for Kids connects leading pediatric specialists with families to providebest-in-class pediatric therapy, nursing, and school-based services. We seamlessly integrate into children's lives by bringing individualized care to children where they live, work, and play.

Our pediatric specialists are committed to providing high-quality pediatric services that help children and families live their best lives. We empower our community of clinicians to meet children where they are by providing the support and resources necessary to decrease administrative burdens. This focus allows our clinicians to obtain optimal work-life balance.

The Clinical Compliance Orders Specialist is responsible for overseeing the accuracy, timeliness, and compliance of all physician orders and clinical documentation within assigned regions. This role ensures that all orders meet regulatory, payer, and company standards while supporting caregivers, nurses, and clinical staff in maintaining continuous care authorization and audit readiness. The position requires a strong understanding of clinical operations, documentation requirements, and compliance standards within private duty nursing environments.
Department: Compliance
Reports To: Clinical Compliance Orders Manager
Qualifications:
Education:
Licensed Practical Nurse (LPN).
Equivalent healthcare administration or compliance background may be considered.

Experience:
Minimum 3 years of experience in home health, private duty nursing, or healthcare compliance required. Strong knowledge of PDN regulations, Medicaid and managed care documentation requirements.
Prior experience managing clinical documentation, orders, or audit processes.

Skills & Abilities:
Excellent attention to detail and organizational skills.
Strong understanding of HIPAA and healthcare compliance standards. Proficient in EMR systems and Microsoft Office Suite.
Effective communicator with physicians, clinicians, and administrative staff. Ability to multitask in a fast-paced environment and meet deadlines.
Ability to read, write and communicate in English.

Physical Requirements:
• Light to moderate physical exertion regularly such as: lifting, bending, pushing, pulling, stopping, kneeling, and reaching.
• Ability to lift and carry up to 30 pounds such as: books, papers, files, medical/office supplies etc. frequently.
• Ability to sit or stand for extended periods of time in the work area.
• Ability to transport oneself to and from multiple work sites.

Primary Responsibilities:
• Review, track, and manage all incoming and expiring physician orders.
• Ensure physician orders are complete, signed, and dated per state and payer requirements.
• Maintain compliance with federal, state, and payer regulations regarding clinical documentation and orders.
• Collaborate with nursing staff and case managers to ensure plan of care updates are accurate and submitted timely.
• Audit clinical records regularly to identify missing documentation or compliance risks.
• Serve as the primary liaison between field nurses, physicians, and the administrative team regarding orders and documentation compliance.
• Communicate with physicians' offices to obtain signed orders and clarify medical documentation as needed.
• Partner with scheduling and authorizations departments to ensure orders align with approved hours and care authorizations.
• Support clinical leadership in responding to payer audits and documentation reviews.
• Develop and maintain workflows for tracking and follow-up of physician orders.
• Provide training and support to clinical and administrative staff on documentation and order management requirements.
• Monitor and report key compliance metrics to leadership (e.g., order turnaround time, compliance rates).
• Recommend and implement process improvements to enhance accuracy and efficiency in order management.
Other Responsibilities For All Staff:
• Embody the Care Options For Kids promise of bringing love, light and laughter into the homes and communities we serve.
• Treat and communicate with clients, families, co-workers, referral sources and caregivers with courtesy, respect, and consideration.
• Maintain confidentiality of all clients, caregiver, and business information.
• Comply with all applicable laws, regulations, policies, procedures, and guidelines.
• Conserve resources by using equipment and supplies as necessary to perform job duties.
• Report to work as assigned or scheduled timely. Follow procedures for notification of absence or time- off requests.
• Maintain professional/technical competency and proficiency of job responsibilities by attending and participating in meetings, conferences and education programs as requested.
• Perform all job responsibilities with a friendly, positive, and collaborative attitude.

If you are the best at what you do, and are ready to work with an innovative, positive and supportive organization, please contact us today.

Care Options For Kids is an equal opportunity employer. The Equal Employment Opportunity Policy of Care Options For Kids is to provide a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. Care Options For Kids hires and promotes individuals solely on the basis of their qualifications for the job to be filled. Care Options For Kids believes that associates should be provided with a working environment which enables each associate to be productive and to work to the best of his or her ability. We do not condone or tolerate an atmosphere of intimidation or harassment based on race, color, religion, national origin, gender, sexual orientation, age, marital status or disability. We expect and require the cooperation of all associates in maintaining a discrimination and harassment-free atmosphere.

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