Director, Compliance

Great Expressions Dental Centers•Southfield, MI

4d•Hybrid

About The Position

The Director, Compliance – Privacy Officer is responsible for leading the Company’s compliance and Patient Services teams. The Director, Compliance is responsible for ensuring that the Company’s and its Affiliated Practices’ Compliance Program is effective in preventing, detecting, and correcting instances of noncompliance with applicable laws, regulations and other governmental and industry guidance. As the Privacy Officer, the Director, Compliance will develop, manage, and implement processes to ensure that the Company and its Affiliated Practices comply with applicable federal and state regulations and guidelines regarding access to and use of protected health information (PHI). The Director, Compliance – Privacy Officer reports to the Chief Clinical Officer, and also keeps the Company’s Compliance Committee and Board of Directors abreast of important regulatory and compliance issues. This position is located at our corporate office in Southfield, MI and has a hybrid schedule of Monday-Thursday in office and Friday remote.

Requirements

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

Nice To Haves

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.

Responsibilities

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
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
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.