Director of Nursing Jobs in USA with Visa Sponsorship
Director of Nursing roles at U.S. hospitals regularly attract H-1B visa and EB-3 sponsorship, since the position qualifies as a specialty occupation requiring a nursing degree and clinical leadership experience. Many health systems will file both a work visa and begin PERM labor certification simultaneously to secure your long-term status.
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Get Access To All JobsINTRODUCTION
The Senior Director of Nursing provides clinical and operational leadership for nursing and medical support services across Heartshare’s OPWDD-regulated residential programs. This position ensures safe, coordinated, person-centered healthcare that supports the health, dignity, independence, and changing needs of individuals with intellectual and developmental disabilities. Reporting to the Vice President of Clinical Services, the Senior Director directly supervises Clinical Nurse Specialists (CNSs) and the Director of Medical Support Professionals. CNSs supervise their assigned nursing staff, while the Director of Medical Support Professionals supervises MSPs. In partnership with Residential leadership and interdisciplinary teams, the Senior Director establishes consistent standards, strengthens staff accountability, ensures regulatory compliance, and manages resources effectively.
ESSENTIAL FUNCTIONS AND PRIMARY RESPONSIBILITIES
Leadership and Workforce Management:
- Supervise, coach, and evaluate CNSs and the Director of Medical Support Professionals, holding them accountable for staff performance, quality of services, communication, and timely resolution of concerns.
- Establish clear responsibilities and workflows across nursing, MSP, and Residential/Article 16 teams, including handoffs, follow-up, and escalation procedures.
- Oversee recruitment, onboarding, staff development, and performance management through the respective supervisors and in collaboration with Human Resources.
- Review biweekly payroll submissions from all nursing staff to ensure timesheets are accurate, complete, and approved within established deadlines. Coordinate with HR and Payroll to complete and process any necessary personnel action forms.
- Evaluate assignments and coverage based on individual acuity, workload, geographic distribution, and regulatory requirements. Maintain an effective nursing on-call structure and conduct regular program visits.
- Monitor and oversee temporary staffing utilization and nursing overtime to ensure coverage needs are met efficiently, staffing resources are used appropriately, and overtime is managed in accordance with organizational expectations and budgetary goals.
Clinical Oversight and Care Coordination:
- Ensure timely completion and implementation of nursing assessments, individualized Plans of Nursing Services, and health-related protocols, including supports for individuals with complex medical needs.
- Establish consistent processes for recognizing changes in health status, obtaining medical evaluation, implementing practitioner orders, and completing follow-up.
- Partner with Residential leadership to ensure completion of preventive care, screenings, specialty services, testing, and recommended treatment. Support approaches that promote independence and aging in place.
- Oversee nursing coordination of hospital discharges and emergency department follow-up, including medication reconciliation and staff instruction. Participate in admission and transition reviews to assess healthcare needs, staffing capacity, equipment, and competencies.
Medication Safety, Compliance, and Quality:
- Oversee medication management, including administration practices, documentation, storage, reconciliation, pharmacy coordination, and controlled substance accountability.
- Ensure appropriate nursing training and supervision of staff performing permitted health-related tasks. Oversee medication administration certification, recertification, and individual-specific competency processes.
- Maintain compliance with applicable OPWDD requirements, New York State nursing practice standards, and agency policies through audits, site reviews, and corrective action monitoring.
- Partner with Quality Assurance and Residential leadership to address clinical incidents, medication errors, and complaints; implement immediate protections; and reduce recurring risks. Develop and recommend policies and procedures through established approval processes.
Operational Management and Performance Improvement:
- Assist in developing nursing and medical support budgets and manage approved resources. Monitor vacancies, overtime, agency utilization, and workload to maintain appropriate coverage and reduce avoidable expenditures.
- Ensure timely clinical assessments and documentation supporting Higher Needs Funding requests in collaboration with Clinical Services, Residential Services, and Finance.
- Partner with Residential leadership on hospital accompaniment plans, clarifying clinical needs, staff responsibilities, competencies, and escalation procedures.
- Monitor clinical outcomes, healthcare follow-up, staff competency, compliance, and workforce utilization. Implement improvement plans with clear ownership and deadlines, evaluate appropriate technology, and promptly report significant risks to the Vice President of Clinical Services.
- Performs other job-related duties as assigned, consistent with the scope, responsibilities, and level of the position, and in compliance with applicable laws, regulations, and organizational policies.
REQUIRED QUALIFICATIONS:
- Bachelor of Science in Nursing (BSN), or equivalent experience.
- Current New York State Registered Professional Nurse license and registration in good standing.
- At least seven years of progressively responsible nursing experience, including three years in nursing leadership or management.
- Experience serving individuals with intellectual and developmental disabilities in OPWDD-regulated residential programs.
- Knowledge of OPWDD nursing requirements, Plans of Nursing Services, medication administration oversight, and supervision of unlicensed staff performing permitted nursing tasks.
- Experience supervising leaders and coordinating services across multiple locations.
- Demonstrated ability to manage clinical risk, strengthen healthcare coordination, address performance concerns, and implement quality improvements.
- Strong clinical judgment, communication, organizational, and problem-solving skills; proficiency with electronic health records and performance reporting.
PREFERRED QUALIFICATIONS:
- Master of Science in Nursing (MSN) strongly preferred.
- Experience supporting medically complex individuals and people experiencing age-related changes.
- Experience overseeing medical support staff or healthcare appointment coordination.
- Experience with budgets, workforce planning, OPWDD surveys, and medication administration training.
BENEFITS
At HeartShare we offer a comprehensive benefit package based on full-time/part-time status. You can expect:
- Rewarding Work in a team environment.
- Paid vacation, sick, personal days, and holidays.
- 403(B) retirement plans with employer contribution.
- Health, dental, vision and life insurance.
- Employee Assistance Program (EAP).
- Flexible spending account (Dependent Care, Medical, Parking, and Transit).
- Employee Appreciation Programs and Events.
- Tuition Assistance Program.
- Professional Development opportunities.
- Wellhub Discount.
- Verizon Wireless Discount.
- BJs Membership discount.
- Discounts on Broadway tickets, movie tickets, theme parks, sporting events, gift certificates & more.
HeartShare is an Equal Opportunity Employer (EOE). If you need to request accommodation during the recruiting process, please reach out to Leaves@heartshare.org.
ABOUT HEARTSHARE
Who WE ARE:
For over 150 years, Heartshare has been dedicated to championing and empowering New Yorkers society has too often overlooked and underestimated.
HeartShare Human Services of New York nurtures and empowers children and adults with intellectual and developmental disabilities.
INTRODUCTION
The Senior Director of Nursing provides clinical and operational leadership for nursing and medical support services across Heartshare’s OPWDD-regulated residential programs. This position ensures safe, coordinated, person-centered healthcare that supports the health, dignity, independence, and changing needs of individuals with intellectual and developmental disabilities. Reporting to the Vice President of Clinical Services, the Senior Director directly supervises Clinical Nurse Specialists (CNSs) and the Director of Medical Support Professionals. CNSs supervise their assigned nursing staff, while the Director of Medical Support Professionals supervises MSPs. In partnership with Residential leadership and interdisciplinary teams, the Senior Director establishes consistent standards, strengthens staff accountability, ensures regulatory compliance, and manages resources effectively.
ESSENTIAL FUNCTIONS AND PRIMARY RESPONSIBILITIES
Leadership and Workforce Management:
- Supervise, coach, and evaluate CNSs and the Director of Medical Support Professionals, holding them accountable for staff performance, quality of services, communication, and timely resolution of concerns.
- Establish clear responsibilities and workflows across nursing, MSP, and Residential/Article 16 teams, including handoffs, follow-up, and escalation procedures.
- Oversee recruitment, onboarding, staff development, and performance management through the respective supervisors and in collaboration with Human Resources.
- Review biweekly payroll submissions from all nursing staff to ensure timesheets are accurate, complete, and approved within established deadlines. Coordinate with HR and Payroll to complete and process any necessary personnel action forms.
- Evaluate assignments and coverage based on individual acuity, workload, geographic distribution, and regulatory requirements. Maintain an effective nursing on-call structure and conduct regular program visits.
- Monitor and oversee temporary staffing utilization and nursing overtime to ensure coverage needs are met efficiently, staffing resources are used appropriately, and overtime is managed in accordance with organizational expectations and budgetary goals.
Clinical Oversight and Care Coordination:
- Ensure timely completion and implementation of nursing assessments, individualized Plans of Nursing Services, and health-related protocols, including supports for individuals with complex medical needs.
- Establish consistent processes for recognizing changes in health status, obtaining medical evaluation, implementing practitioner orders, and completing follow-up.
- Partner with Residential leadership to ensure completion of preventive care, screenings, specialty services, testing, and recommended treatment. Support approaches that promote independence and aging in place.
- Oversee nursing coordination of hospital discharges and emergency department follow-up, including medication reconciliation and staff instruction. Participate in admission and transition reviews to assess healthcare needs, staffing capacity, equipment, and competencies.
Medication Safety, Compliance, and Quality:
- Oversee medication management, including administration practices, documentation, storage, reconciliation, pharmacy coordination, and controlled substance accountability.
- Ensure appropriate nursing training and supervision of staff performing permitted health-related tasks. Oversee medication administration certification, recertification, and individual-specific competency processes.
- Maintain compliance with applicable OPWDD requirements, New York State nursing practice standards, and agency policies through audits, site reviews, and corrective action monitoring.
- Partner with Quality Assurance and Residential leadership to address clinical incidents, medication errors, and complaints; implement immediate protections; and reduce recurring risks. Develop and recommend policies and procedures through established approval processes.
Operational Management and Performance Improvement:
- Assist in developing nursing and medical support budgets and manage approved resources. Monitor vacancies, overtime, agency utilization, and workload to maintain appropriate coverage and reduce avoidable expenditures.
- Ensure timely clinical assessments and documentation supporting Higher Needs Funding requests in collaboration with Clinical Services, Residential Services, and Finance.
- Partner with Residential leadership on hospital accompaniment plans, clarifying clinical needs, staff responsibilities, competencies, and escalation procedures.
- Monitor clinical outcomes, healthcare follow-up, staff competency, compliance, and workforce utilization. Implement improvement plans with clear ownership and deadlines, evaluate appropriate technology, and promptly report significant risks to the Vice President of Clinical Services.
- Performs other job-related duties as assigned, consistent with the scope, responsibilities, and level of the position, and in compliance with applicable laws, regulations, and organizational policies.
REQUIRED QUALIFICATIONS:
- Bachelor of Science in Nursing (BSN), or equivalent experience.
- Current New York State Registered Professional Nurse license and registration in good standing.
- At least seven years of progressively responsible nursing experience, including three years in nursing leadership or management.
- Experience serving individuals with intellectual and developmental disabilities in OPWDD-regulated residential programs.
- Knowledge of OPWDD nursing requirements, Plans of Nursing Services, medication administration oversight, and supervision of unlicensed staff performing permitted nursing tasks.
- Experience supervising leaders and coordinating services across multiple locations.
- Demonstrated ability to manage clinical risk, strengthen healthcare coordination, address performance concerns, and implement quality improvements.
- Strong clinical judgment, communication, organizational, and problem-solving skills; proficiency with electronic health records and performance reporting.
PREFERRED QUALIFICATIONS:
- Master of Science in Nursing (MSN) strongly preferred.
- Experience supporting medically complex individuals and people experiencing age-related changes.
- Experience overseeing medical support staff or healthcare appointment coordination.
- Experience with budgets, workforce planning, OPWDD surveys, and medication administration training.
BENEFITS
At HeartShare we offer a comprehensive benefit package based on full-time/part-time status. You can expect:
- Rewarding Work in a team environment.
- Paid vacation, sick, personal days, and holidays.
- 403(B) retirement plans with employer contribution.
- Health, dental, vision and life insurance.
- Employee Assistance Program (EAP).
- Flexible spending account (Dependent Care, Medical, Parking, and Transit).
- Employee Appreciation Programs and Events.
- Tuition Assistance Program.
- Professional Development opportunities.
- Wellhub Discount.
- Verizon Wireless Discount.
- BJs Membership discount.
- Discounts on Broadway tickets, movie tickets, theme parks, sporting events, gift certificates & more.
HeartShare is an Equal Opportunity Employer (EOE). If you need to request accommodation during the recruiting process, please reach out to Leaves@heartshare.org.
ABOUT HEARTSHARE
Who WE ARE:
For over 150 years, Heartshare has been dedicated to championing and empowering New Yorkers society has too often overlooked and underestimated.
HeartShare Human Services of New York nurtures and empowers children and adults with intellectual and developmental disabilities.
See all 202+ Director of Nursing Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Director of Nursing roles.
Get Access To All JobsTips for Finding Director of Nursing Jobs
Verify your credentials meet state licensure
Before applying, confirm your foreign nursing degree has been evaluated by a CGFNS-approved credential evaluation service and that you hold or can transfer an RN license in your target state. Unlicensed candidates stall sponsorship timelines significantly.
Target health systems with PERM filing history
Large hospital networks and regional health systems file PERM labor certifications far more routinely than small clinics. Use the OFLC public disclosure data to identify which employers have certified DON-level positions in your preferred metro area.
Search verified sponsoring employers on Migrate Mate
Migrate Mate lists U.S. healthcare employers with verified sponsorship history for nursing leadership roles, searchable by location and role type. Start your search there to avoid spending time on employers who have never filed for Director of Nursing positions.
Clarify whether the role triggers H-1B or EB-3
Some employers default to EB-3 for nursing roles even when H-1B is faster for candidates already in the U.S. Ask HR explicitly which pathway they intend to file, since the PERM process under EB-3 adds 12 to 24 months before an immigrant visa becomes available.
Align your offer letter scope with LCA requirements
Your job offer must describe duties consistent with a specialty occupation under USCIS guidelines. Vague titles like 'clinical manager' without degree requirements in the offer can trigger a Request for Evidence. Ask the employer to specify the BSN or MSN requirement in writing before the LCA is filed with DOL.
Account for EB-3 priority date backlogs early
If you're born in a high-demand country for employment-based green cards, your EB-3 priority date may face a multi-year backlog. Raise this during offer negotiation so the employer understands your H-1B extensions will need to continue until your immigrant visa becomes current.
Frequently Asked Questions
Does a Director of Nursing role qualify for H-1B sponsorship?
Yes. The Director of Nursing qualifies as a specialty occupation under USCIS criteria because the role typically requires at least a Bachelor of Science in Nursing as a minimum entry requirement. USCIS expects the employer to document that a BSN or higher is standard for the position, which most hospital systems can support through their job descriptions and internal policy.
Which visa types are realistic for a foreign-trained Director of Nursing?
H-1B is the most common work visa for this role, covering an initial period of up to three years, extendable to six. EB-3 skilled worker is the standard green card pathway, requiring PERM labor certification through DOL. Some employers will file both concurrently. TN visa is not available for Director of Nursing roles, as the USMCA profession list does not include nursing administration positions.
How do I find hospitals actively sponsoring Director of Nursing positions?
Migrate Mate lists U.S. healthcare employers with verified sponsorship history for nursing leadership roles, so you can focus only on organizations that have actually filed for comparable positions. That filter alone saves significant time compared to applying broadly and discovering sponsorship reluctance late in the interview process.
Will my foreign nursing degree satisfy the specialty occupation requirement?
It can, but it requires a credential evaluation from a CGFNS-approved organization confirming your degree is equivalent to a U.S. BSN. USCIS reviews the evaluation as part of the H-1B petition. If your credential evaluator finds equivalency to only an associate degree, you may need to supplement with verified work experience using the three-for-one substitution rule under USCIS policy.
What makes PERM labor certification harder for Director of Nursing roles?
DOL requires the employer to conduct a genuine recruitment test proving no qualified U.S. worker is available at the prevailing wage. For Director of Nursing roles, the pool of domestic candidates is relatively large, which means employers must document each step of recruitment carefully. Any procedural gap in the recruitment record can result in a DOL audit, extending the PERM timeline well beyond the standard 6 to 12 months.
What is the prevailing wage requirement for sponsored Director of Nursing jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.