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.