Federally Qualified Health Centers are a structural exception to all of this. FQHCs are built around a federally mandated set of primary and preventive care services — including medical nutrition therapy and diabetes self-management training — and they don’t operate inpatient kitchens, retail cafés, catering departments, or vending operations. A WIC Nutritionist role at a Connecticut FQHC is built entirely around nutrition assessment, education, and individualized care plans; a WIC Lead Nutritionist role at an FQHC in North Carolina centers on nutrition counseling, diet, and gestational diabetes management. There’s no foodservice infrastructure for a nutrition leadership title to expand into, so the ambiguity that exists in hospital postings largely doesn’t apply — “Director of Nutrition Services” at an FQHC is close to a de facto clinical title, simply because there’s nothing else in the building for it to mean.

If you’re evaluating a move from a hospital system into community health, that’s worth knowing going in: the title-matching exercise that matters when comparing hospital postings against each other isn’t really necessary when the employer is an FQHC. The scope is set by what the organization is, not by which version of the title they happened to use.