Director of Clinical Policy

Integrated Home Care Services, Inc.

Director of Clinical Policy leading clinical policy development and implementation for home health and DME services at IHCS. Ensuring regulatory compliance and evidence-based practices.

Posted 6/5/2026full-timeRemote • Florida • 🇺🇸 United StatesLeadWebsite

About the role

Key responsibilities & impact

Responsible for leading the development, implementation, and continuous improvement of clinical policies, criteria, and workflows supporting home health and durable medical equipment (DME) services across all lines of business.
Ensure that clinical criteria are evidence-based, operationally efficient, and aligned with Medicare, Medicaid, and commercial payer requirements.
Partner closely with clinical operations, utilization management, technology, and product teams to design and optimize scalable, automated workflows.

Requirements

What you’ll need

Lead the development, standardization, and maintenance of clinical criteria for all home health and DME services across lines of business.
Translate Medicare (NCDs/LCDs), Medicaid, and commercial payer policies into actionable, operational clinical guidelines.
Maintain up-to-date knowledge of Medicare and Medicaid regulations, including coverage determinations, billing requirements, and policy updates.
Collaborate with Medical Directors, UM teams, care management, and provider engagement teams to ensure alignment of clinical policies and operational workflows.

Benefits

Comp & perks

Medical
Vision
Dental
Short- and Long-term insurance
6+ Days of Holidays Pay
17 days of PTO
Employer paid life insurance
401K with employer contribution
Wellness program with reward incentives
Employee recognition and reward programs
Comprehensive paid training program

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical policy developmentclinical criteria standardizationworkflow optimizationevidence-based guidelinesoperational efficiencyMedicare regulationsMedicaid regulationsbilling requirementscoverage determinationspolicy updates

Soft Skills

leadershipcollaborationcommunicationpartneringteamwork