Associate Director of Clinical Nursing Services

Texas Health Action (THA) is a community-informed non-profit organization dedicated to providing access to culturally affirming, quality health services in a safe and supportive environment, with expertise in serving LGBTQIA+ people and those impacted by HIV. Kind Clinic proudly serves Texas with four vibrant locations: two in Austin, one in San Antonio, and another in Dallas plus virtual care services available to all residents across Texas. Bolstered by Waterloo Counseling Center and a passionate team of over 250 dedicated employees and volunteers, THA is at the forefront of promoting healthcare equity and accessibility throughout the state. Read more about THA here: http://texashealthaction.org.

The Associate Director of Clinical Nursing Services is responsible for system-wide clinical oversight, professional nursing practice leadership, and competency assurance for all nursing staff across Texas Health Action services in Texas. This role provides authoritative clinical direction, nursing practice standards, and clinical escalation support across multiple operational settings while preserving existing operational reporting structures.

Core Functions

Nursing Operations & Workforce Management

• Support nurse staffing models and deployment in partnership with Clinic Administrators and Clinical Operations leadership to ensure safe, effective clinic operations.
• Work in tandem with operational managers and the Patient Access Nurse Manager to ensure adequate nurse staffing for clinical operations.
• Serve as the direct clinical supervisor for clinic-based and outreach nursing staff, with authority over nursing practice standards, clinical competency validation, delegation, and remediation related to clinical performance.
• Plan regular nurse team meetings and agendas for team building, professional development, and communication.
• Perform both direct and non-direct patient care nursing tasks as staffing requires, with direct care serving as a secondary function to leadership responsibilities.
• Ensure initial and ongoing clinical competency validation for nursing staff in collaboration with the Clinical Education Manager, including documentation of clinical skills, delegation competency, and role-specific requirements across clinics, Patient Support Center, and outreach programs.

Clinical Practice Oversight

• Maintain clinical credibility through observation and limited direct patient care as needed.
• Ensure compliance with Texas nursing scope of practice requirements for RNs, LVNs, and MAs.
• Maintain clinical competencies through direct-care observation and/or practice within the clinics. Serve as the primary clinical escalation point for nursing-related clinical questions, adverse events, and patient safety concerns.
• Participate in recurring Kind Clinic manager meetings to ensure cohesive clinical–administrative care coordination and delivery.
• Serve as the organizational subject matter expert (SME) on Texas Board of Nursing rules, scope of practice, delegation standards, and supervision requirements, ensuring consistent interpretation and application across all clinical settings.
• Establish, oversee, and periodically review nursing delegation frameworks and the implementation of physician-issued standing delegation orders (SDOs), in collaboration with Medical Directors, in accordance with Texas Board of Nursing and Texas Medical Board requirements and evidence-based care models.

Professional Accountability & Safe Practice

• Promote a culture of safe nursing practice and professional accountability consistent with Texas Board of Nursing standards.
• Support nursing staff in exercising professional judgment, including the duty to question orders or operational directives that may place patients at risk.
• Ensure mechanisms exist for nurses to escalate clinical concerns without fear of retaliation.

Matrixed Clinical Authority

• Exercise system-wide clinical authority over nursing practice and nursing personnel for all RNs and LVNs, regardless of local operational reporting relationships. Ensure that MA clinical activities are performed in accordance with physician-issued standing delegation orders and under appropriate licensed provider supervision and monitor adherence to established clinical protocols.
• Non-clinical administrative supervision, scheduling, timekeeping, and HR process management remain the responsibility of the respective site operational leader (e.g., Clinic Administrator, Director of Patient Access, Director of Community Health).
• Provide clinical direction, guidance, and escalation support to nursing staff embedded in:
• Clinic operations
• Patient Support Center
• Outreach and community-based services
• Partner with unlicensed operational leaders to address performance issues that involve both clinical and administrative components, with clear delineation of responsibilities.
• Ensure appropriate clinical supervision of nursing staff consistent with Texas Board of Nursing requirements, including availability for consultation, oversight of delegated tasks, and intervention when nursing practice is unsafe.
• This role does not supervise or direct the clinical practice of physicians or advanced practice providers; medical decision-making authority remains with Medical Directors and licensed providers in accordance with Texas Medical Board requirements.
• Escalate unresolved clinical practice concerns to the CMO for final clinical authority, and escalate operational, quality, or regulatory matters through the appropriate leadership channels, consistent with the organization’s matrixed governance structure.

Quality, Safety & Regulatory Compliance (Implementation Role)

• Partner with the System Director of Clinical Quality Improvement to support audits, chart reviews, quality improvement initiatives, and ongoing monitoring of nursing practice, while maintaining separation between audit functions and nursing remediation responsibilities.
• Participate in nursing-focused chart reviews and incident analyses in collaboration with the System Director of Clinical Quality Improvement, utilizing established review tools, methodologies, and reporting thresholds.
• Design and implement nursing practice improvement and corrective action plans in response to identified findings, ensuring timely remediation and sustained adherence to clinical standards.
• Compile data related to audits and reports and support corrective action plans as needed.
• Support the System Director of Clinical Quality Improvement in the development and standardization of organization-wide clinical policy frameworks and clinical practice standards.
• Collaborate with the Clinical Compliance Manager on policies required for regulatory and statutory compliance.
• Own the implementation, training, and adherence monitoring of nursing-specific policies, standard operating procedures (SOPs), and delegation workflows across all care delivery settings.
• Collaborate closely with the Clinical Compliance Manager, who retains primary responsibility for regulatory interpretation, external reporting, and oversight of compliance programs, to ensure nursing adherence to and operational implementation of, but not limited to:

• • • Texas Administrative Code and Board of Nursing requirements
    • DSHS STI/HIV Program inclusive of Texas Infertility Prevention Project (TIPP)
    • Adult Safety Net (ASN) vaccine program and Vaccine Management Plan (VMP)
    • Class D Pharmacy regulations
    • Texas ImmTrac2 immunization reporting
    • Texas DSHS notifiable condition reporting

• Lead nursing-focused remediation and corrective action plans resulting from audits, incidents, or regulatory findings.
• Oversees the organization’s Nursing Peer Review program in accordance with Texas Occupations Code and Texas Administrative Code.

Cross-Functional Leadership & Communication

• Partner closely with Clinic Administrators to balance clinical quality, patient experience, and operational flow without direct supervisory authority over administrative staff.
• Hiring decisions and overall performance management are conducted in shared partnership between the Associate Director of Clinical Nursing Services and the applicable operational leader, with clinical performance components led by the Associate Director of Clinical Nursing Services and administrative components led by the operational supervisor.
• Communicate appropriately and tactfully with staff, consultants, patients, partners, and community.
• Escalate unresolved nursing practices or patient safety concerns through the clinical leadership chain when operational constraints conflict with safe nursing practices.
• Reduce conflict and increase patient and staff satisfaction whenever possible.
• Participate in and facilitate in-services, trainings, and meetings as needed.
• Perform other duties as assigned.

Compensation

Based on the position’s duties and requirements, this role has a starting annual salary of $102,335. The initial salary will be determined by the selected candidate’s qualifications and relevant experience.

We’re also offering a $2,500 signing bonus for this role as a welcome to our team—$1,250 paid with your first paycheck after signing, and the remaining $1,250 paid after 90 days of employment.

Requirements

Education & Licensure

• BSN (Bachelor of Science in Nursing)
• Active, unrestricted Texas RN license required.

Experience

• 5+ years patient care experience in an outpatient clinic setting required.
• 2+ years of experience in working with diverse populations, including LGBTQIA+ and other marginalized populations.
• Microsoft Office Skills with an ability to become familiar with company or position specific programs or software.

Additional Preferred Requirements

• Experience as a clinical nurse manager and MSN (Master of Science in Nursing) are preferred; however, a combination of education, relevant certifications, and transferable experience will also be taken into consideration.
• Bilingual proficiency in English/Spanish is an asset.
• Experience with Athenahealth electronic medical record documentation.
• Experience in HIV testing, HIV services, STI testing, and treatment clinic.

Knowledge Skills and Abilities

• Must have basic PC skills that include a combination of working in a Windows Operating System and Microsoft Outlook, Word, and Excel.
• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards.
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups.
• Well-developed verbal and written communication skills in English; Additional language abilities desirable.
• Ability to work well under pressure with minimal supervision.
• Ability to effectively interact with persons of widely diverse roles, backgrounds, cultures, and socio-economic classes, those in crises or resistant or negative toward organizations.
• Ability to apply time management practices to prioritize, schedule and complete work effectively to comply with mandated policies and deadlines.
• Ability to work on multiple tasks or parts of tasks simultaneously to ensure timely completion of work activities.
• Must be able to work productively with other departments and employees.
• Ability to work with professionals from various partners and organizations.
• Usually works forty (40) hours per week, some weekends may be required.
• Ability to successfully manage conflict, negotiating “win-win” solutions.
• Must be able to multi-task, prioritize with strong time management skills.
• Exceptional follow-through on tasks and assignments
• Must possess leadership qualities and be able to supervise and secure the cooperation of staff

Physical Requirements/Environmental Conditions

Perform the following with or without reasonable accommodations:

• Ability to stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, grasp, and be able to perceive the attributes of objects such as size, shape, temperature, and/or texture by touching with skin, particularly that of the fingertips.
• Ability to express and exchange ideas via spoken word during activities in which they must convey detail or important spoken instructions to others accurately, sometimes quickly and loudly.
• Hearing to perceive the nature of sound with no less than 40 db loss @ Hz, 1000 Hz, and 2000 Hz with or without correction; ability to perceive detailed information orally and make fine discriminations in sound.
• Perform repetitive motions with wrists, hands, and fingers. Individual must be able to exert up to 100 pounds of force occasionally and to be able to lift, carry, push, pull, or otherwise move objects.
• Work requires a minimum standard of visual acuity with or without correction that will enable people in the role to complete administrative and clerical tasks, as well as inspect and analyze.
• Must be able to work and concentrate amidst distractions such as noise, conversation, and foot traffic; ability to handle interruptions often and be able to move from one task to another.
• While worker may possibly be subjected to temperature changes, the worker is generally not substantially exposed to adverse environmental conditions as the work is predominantly inside.

Benefits

• Health Care Plan (Medical, Dental & Vision)
• Retirement Plan (403b)
• Life Insurance (Basic, Voluntary & AD&D)
• Paid Time Off (Vacation, Sick & Holidays)
• Short-Term & Long-Term Disability
• Training & Development
• Parental Leave
• Longevity Pay

Applicant Information

• Submitting official transcripts, diplomas, certifications and licenses may be required prior to final offer. Unofficial transcripts and copies of other relevant documents may be attached to the application for consideration in advance.
• Information regarding employment history as it relates to the qualifications of the position may be needed for employment verification.
• The applicant selected for employment is subject to a pre-employment background check. A history of conviction may not automatically disqualify an applicant. Applicants with a history of conviction may be considered on a case-by-case basis, after individualized assessment of factors including the nature of the conviction, the job duties and responsibilities, the length of time since the conviction, and evidence of mitigation or rehabilitation. If required for the position, a physical, motor vehicle record evaluation, and additional background checks may be conducted.

EEO Statement: Texas Health Action is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.