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Great Expressions Dental Centers · 2 days ago

Director, Compliance

Southfield, MI

Contract

Hybrid

Lead/Staff, Director/Executive

5+ years exp

Great Expressions Dental Centers is a leader in dental innovation, seeking a Director, Compliance – Privacy Officer to oversee compliance and patient services teams. The role involves developing and managing compliance programs, conducting audits, and ensuring adherence to healthcare regulations regarding protected health information.

Health CareMedical

Responsibilities

Develop and Implement Compliance Programs

Create policies and procedures to ensure regulatory compliance

Monitor and update these programs as regulations evolve

Conduct Regular Audits

Review patient records, billing practices, infection control, and privacy protocols

Identify areas of risk and recommend corrective actions

Staff Training and Education

Train dental staff on compliance topics like HIPAA, OSHA, and state-specific laws

Ensure ongoing education to keep up with regulatory changes

Monitor Legal and Regulatory Changes

Stay informed about updates in healthcare and dental regulations

Adjust internal policies accordingly

Liaison with Regulatory Bodies

Serve as the point of contact during external audits, inspections, or investigations

Prepare reports and documentation for compliance reviews

Upholding the Company’s Compliance Program by driving a culture of compliance rooted in ethical practices, policies, and programs which encourage Team Members to report suspected improprieties without fear of retaliation or retribution

As the Director of Compliance, responsible for the daily operation of the Company’s and Affiliated Practices’ privacy practices program, including maintaining policies related to protected health information, monitoring program compliance, investigating, tracking, and responding to privacy incidents and breaches

Collaborating with the Compliance Committee and legal counsel to evaluate the organization’s existing policies and procedures for HIPAA compliance by performing HIPAA risk assessments to identify and address privacy policies and procedures that require improvement

Assisting with annual compliance risk assessment of the Company and Affiliated Practices to identify each organization’s particular risks related to general compliance issues and pertinent federal and state laws, regulations and standards including, without limitation: fraud, waste and abuse; the Anti-Kickback Statute (AKS); and the False Claims Act, as well as inappropriate gifts and relationships with referral sources that could put the company at risk for noncompliance

Assisting with the coordination of the Company’s compliance audit and monitoring activities, including billing and coding audits as well as independently investigate all compliance-related reports, inquiries, recommendations for corrective action plan, and all other compliance-related matters reported through internal hotlines

Ensuring that appropriate issue-specific remedial training is conducted for Team Members - either individually or in groups – in response to internal audits, reviews, or mandatory corrective action plans that uncover unethical or improper business practices

Recommending periodic updates to the Company’s Compliance Program as necessary to reflect changes in the law, the Company’s needs, or contractual obligations with payers

Assisting with setting the agendas for, and conducting, the quarterly meetings of the Company’s Compliance Committee

Perform other related duties as assigned

Qualification

Compliance ProgramsHIPAA ComplianceHealthcare AdministrationDental ComplianceAnalytical SkillsLeadership SkillsInterpersonal SkillsProject Management

Required

Subject Matter Expertise in dentistry, dental compliance, and dental clinical compliance including clinical protocols, billing, and insurance compliance in dental practices

Ability to use independent judgment and to manage and impart confidential information

In depth knowledge of public policies, legislation, guidelines, and standards pertaining to fraud, waste and abuse, HIPAA and other compliance matters pertaining to the health care industry

Demonstrated ability to develop institutional policies and procedures

Supervisory, employee development, team building, and leadership skills

Strong critical thinking skills and the ability to analyze, summarize, and effectively present data

Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community

Demonstrated understanding of compliance systems and controls

Knowledge and understanding of investigation, negotiation, mediation and complaint resolution process of high level/sensitive claims on behalf of the Company

Bachelor's degree required

5+ years of healthcare administration experience in a large-scale operating environment preferably in a dental or clinical setting

Knowledge of healthcare compliance in a healthcare system, including deep experience with HIPAA

Strong analytical and problem-solving skills

Excellent communication and interpersonal abilities

Attention to detail, project management, and organizational skills

Preferred

Bachelor's degree in healthcare administration, public health, law, or a related field is preferred

Experience in a DSO environment is particularly valuable due to the complexity of managing compliance across multiple sites and varying local/state regulations

Advanced degrees or certifications (e.g., CHC – Certified in Healthcare Compliance) are a plus