OverviewWe are looking for a
Director of Clinical Audits and Peer Reviews to join our compliance team. This individual will report to the Compliance Director and assist the Compliance Department i Develop and execute a comprehensive clinical audit and peer review strategy aligned with organizational quality and compliance goals.
Responsibilities: Audit and Compliance Oversight:
- Conduct internal audits, peer audits, and internal investigations
- Manage and respond to external audits (insurance companies, regulatory agencies, state dental boards, legal entities)
- Oversee external insurance payment audits
- Identify compliance risks and implement corrective action plans
- Present compliance workflows and documentation standards
Management of Peer Audit Program:
- Design and select procedures for peer audit review
- Train and educate auditors on audit protocols and software tools
- Analyze peer audit results and present findings to clinical leadership
- Facilitate follow-up and resolution of issues identified during audits
Clinical Review and Risk Management:
- Participate in clinical review of patient and internal complaints
- Support investigations involving clinical care and documentation
- Work with Quality Assurance Committee of the Oral Health Board to address issues identified during clinical reviews
- Participate in Credentialing committee workflows and meetings for clinical review of re-credentialling matters
- Serve as expert for state and federal dental practice act regulations, including allowable and prohibited duties by clinical role
Infection Control and Regulatory Compliance:
- Oversee infection control compliance across supported practices
- Monitor Direct Unit Water Line (DUWL) testing and weekly spore testing completion
- Troubleshoot sterilization and testing issues with offices
- Provide guidance on sterilization, disinfection, and PPE standards
Training and Education:
- Provide onboarding education for new hires
- Deliver ongoing training on compliance, infection control, and vendor tools
- Support adoption of organizational protocols and best practices
Other:
- Monitor key performance indicators (KPIs) related to audits and infection control
- Prepare and deliver quarterly reports to executive leadership
- Collaborate with executive and operational leadership, including the Chair of the Oral Health Board, Vice Presidents of Operations and Clinical Operations, and Regional Directors of Operations.
- Advocate for company-wide clinical standards
Qualifications:- At least eight (8) to ten (10) years experience of in a clinical dental environment
- Comprehensive knowledge of dental procedures and CDT coding
- Understanding of insurance billing practices and documentation requirements
- Knowledge of state Dental Practice Acts and scope of practice for dental healthcare personnel (DHCP)
- Ability to analyze audit findings and provide actionable recommendations
- Ability to interpret radiographic images
- Working knowledge of clinical dentistry across specialties
- Understanding of standard of care and risk exposure
- Knowledge of CDC and ADA infection control guidelines
- Knowledge of OSHA Bloodborne Pathogen (BBP) Standard and workplace safety requirements
- Understanding of best practices for sterilization, disinfection, and dental operatory setup
- Knowledge of regulatory compliance requirements and inspection readiness
- Strong presentation and communication skills
- Proficiency in Open Dental (OD) reporting and MS Office, especially PowerPoint, Word and Excel
- Attention to detail; very organized
- Ability to interact with people at all levels of the corporate structure, prioritize and handle numerous competing demands in a high-volume, fast-paced working environment
- Ability to work independently and complete job responsibilities without significant oversight
Why You'll Love Working Here- Comprehensive Benefits: Including 401(k).
- Paid Time Off: Competitive PTO that grows with your career.
- Career Growth: Opportunities for continuing education and development.
- Exciting Work Environment: A supportive atmosphere that celebrates individuality and teamwork, allowing you to thrive.
Ready to Join Us?Apply today and be part of a team that's revolutionizing dental care!
North American Dental Group-branded practices are independently owned and operated by licensed dentists. The practices receive non-clinical business support services from North American Dental Group, a dental support organization.
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