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Full-time
401(k), Paid Time Off, Continuing Education, Career Development
Posted 44d ago
Apply by Jun 24
~40 hrs/week
Responsibilities
The Director of Clinical Audits and Peer Reviews will develop and execute a comprehensive clinical audit and peer review strategy aligned with organizational quality and compliance goals. They will conduct internal audits, manage external audits, oversee compliance workflows, and provide training and education to staff.
Requirements
Candidates should have at least eight to ten years of experience in a clinical dental environment and a comprehensive knowledge of dental procedures and compliance regulations. Strong analytical skills and the ability to interpret clinical data are essential for this role.
Full job description
Overview
We 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.
Equal Opportunity EmployerWe embrace diversity and are committed to creating an inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, sex, sexual orientation, gender identity, age, national origin, disability, veteran status, or any other legally protected characteristic.
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.
North American Dental Group is a premier dental group with a commitment to industry-leading service and care for EVERY PATIENT, EVERY VISIT.
We have a true partnership with our affiliated dentists enabling them to focus on what they do best and love most… dentistry. With our patient-centric approach, our mission is to serve our doctors and their clinical support teams so they have clinical autonomy to provide the very best treatment focused on EMPATHY, COMPASSION and CARE.
We provide comprehensive support to 230+ dental practices with the understanding that it requires the efforts of everyone to achieve our goals for patient care.
For more information, please visit our website at www.nadentalgroup.com
Offices: 125 Enterprise Dr, Pittsburgh, Pennsylvania 15275, US · 11 South Mill Street, New Castle, PA 16101, US