Clinical Compliance Orders Specialist - LPN

Care Options for Kids connects leading pediatric specialists with families to provide best-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 enhan