The Opportunity:

Abby Care is scaling our capacity to support family caregivers and medically complex patients across the country, and our clinical leadership team is also expanding. We're hiring for a Senior Director of Nursing/Administrator to provide strategic, multi-state clinical leadership and operational governance across a designated region. This high-impact senior leadership role reports to our Head of Clinical Operations, and directly manages, coaches, and holds accountable the local Directors of Nursing (DONs)/Administrators to ensure the highest standards of patient care, operational efficiency, and regulatory compliance.

A savvy leader, serving as the bridge between regional clinical performance and executive leadership comes naturally. Executive presence and strong communication skills are hallmarks of your leadership style, you have a proven ability to distill complex clinical data into actionable insights. Data-driven, you are comfortable utilizing business intelligence tools and clinical dashboards to measure performance and hold leaders accountable. Collaborative, you work easily across teams and balance a macro-level strategic mindset with a rigorous focus on execution; partnering cross-functionally with Senior General Managers, Compliance, HR, and Product teams to scale clinical capacity, exceed quality benchmarks, and ensure continuous survey readiness. If you are excited about the opportunity to build the future of care at home, we'd love to hear from you.

This is a Full-Time Hybrid opportunity based in Nashville, Tennessee.

What you'll work on:

Regional Executive Governance & Accountability

• Executive Report Outs: Own the aggregation, analysis, and presentation of regional clinical and quality performance metrics to the executive team.
• Strategic Alignment: Translate corporate clinical strategies into standardized, actionable operational practices across multiple markets and states.
• Cross-Functional Partnership: Partner closely with Regional Senior General Managers to align clinical quality with market growth targets, and collaborate with HR, Compliance, Finance, and Product/IT teams to optimize operations.

Clinical Capacity & Workforce Strategy

• Macro Capacity Planning: Oversee regional clinical capacity models to ensure local agencies can support census growth, service line expansions, and geographic surges.
• Leadership Development: Standardize onboarding, mentoring, and professional growth pathways for local DONs/Administrators to build a resilient, high-performing leadership pipeline.
• Retention & Culture: Monitor regional nursing turnover and burnout trends; partner with HR to implement regional strategies that champion clinician well-being and engagement.

Quality Benchmarks & Outcome Mastery

• Regional Quality Ownership: Drive regional performance against enterprise clinical quality strategy, QA/QAPI initiatives, and utilization benchmarks.
• Clinical Escalations & Edge Cases: Serve as the regional authority for the review and escalation of complex clinical edge cases, high-risk patient events, or severe adverse incidents.
• Root Cause & Corrective Strategy: Lead regional root-cause analyses for adverse events, ensuring systemic adjustments are implemented across all markets to avoid recurrence, in partnership with compliance, HR and legal as necessary.

Multi-State Regulatory Compliance & Survey Readiness

• Continuous Survey Readiness: Standardize a proactive, "always-ready" culture for CMS Conditions of Participation (CoPs), ACHC/Joint Commission accreditation, and varying state-specific regulations.
• Audit & Response Leadership: Oversee the preparation for, and response to, state surveys and federal audits. Review and sign off on all local Plans of Correction (POC) before execution.
• Risk Mitigation: Work alongside the corporate Compliance team to proactively identify, track, and mitigate legal, financial, and clinical operational risks across the region.

Cross-Functional Workflow & Product Optimization

• Tech & Product Collaboration: Partner directly with the Product/IT teams to drive technical updates that reduce clinician documentation burdens, and standardize clinical workflows across their markets.
• Practice Standardization: Minimize unwarranted practice variations across state lines while ensuring strict adherence to individual state nursing practice acts.

What success looks like:

In 12 months, you will have successfully built a cohesive, high-performing regional nursing organization by standardizing operational workflows, achieving 100% survey readiness across all local agencies, and lowering clinician turnover. You will have established a data-driven governance cadence that directly correlates high clinical quality benchmarks with scalable census growth and seamless cross-functional execution.

What you'll have:

• Bachelor of Science in Nursing (BSN) required; Master of Science in Nursing (MSN), Master of Health Administration (MHA), or MBA strongly preferred.
• Current, unrestricted Registered Nurse (RN) license. Multistate/Compact license eligibility required (and willingness to obtain licensure in additional states within the region as necessary).

• Minimum of 5+ years of progressive home healthcare experience.
• 5+ years of clinical leadership experience in a home health or comparable multi-site setting (e.g., Regional DON, VP of Clinical Operations, or senior-level agency administrator).
• Demonstrated experience managing multi-site teams, successfully leading agencies through state/federal regulatory surveys, and scaling clinical operations during rapid growth.

Benefits:

• Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work - full-time employees are eligible for an annual company performance bonus.
• Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.
• Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.
• Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
• Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.