Compliance Program Manager

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Compliance Program Manager, School of Dental Medicine
The candidate will assist the Director of Compliance for company Medicine Health Sciences Schools in carrying out the School of Dental Medicine’s mission and goals and its Compliance Program. The Compliance Program Manager will provide compliance guidance and education for the School of Dental Medicine. Will assess a variety of complex compliance risk-areas within the School of Dental Medicine to develop a work plan, lead investigations; conduct auditing and monitoring, provide training and education; assess compliance with policies, procedures, and regulations; identify and recommend strategies for process improvements; and prepare written reports. Identify and recommend strategies for process improvement and maintain knowledge of regulatory requirements associated with the School of Dental Medicine. Perform clinical documentation audits analyzing medical record documentation and claims for accuracy of code assignments and other claim fields; determine compliance with policies, procedures, and Federal and state regulations and guidelines; and evaluate the timeliness and appropriateness of claim submissions. In consultation with the Compliance Director for company Medicine Health Sciences Schools and/or company Medicine’s Chief Compliance Officer, design and implement a risk based annual compliance work plan incorporating governmental and other agency regulations and industry alerts, compliance program requirements, and policies and procedures. Prepare and present reports on projects, programs, policies, training, and practices that ensure compliance with Federal, state and local regulatory requirements for company Medicine’s School of Dental Medicine to the Compliance Director for company Medicine Health Sciences Schools and to the School of Dental Medicine’s Compliance Committee on at least a quarterly basis. Conduct audits of the School of Dental Medicine’s compliance risk areas as identified through the annual work plan, in industry alerts, through regulatory agencies, or via other means. Conduct independent medical record documentation and coding/billing audits, assessing the accuracy of code and modifier assignments; determining compliance with appropriate policies, procedures and regulations; and evaluating the timeliness and appropriateness of claim submission. Identify procedural and system weaknesses. Collaborate with compliance resources on audits and projects as needed. Produce high-quality work that is competently and efficiently performed in accordance with department standards. Prepare comprehensive reports making recommendations to correct deficiencies and improve processes. Monitor to identify patterns, trends, and variances during and from audits. Develop reports from the audit results and/or other sources and assess the need for further review or intervention. Develop and provide compliance training and education for all new employees as well as ongoing and annual retraining for company Medicine’s School of Dental Medicine. Ensure the exclusion screenings are completed. Strengthen and enhance company Medicine’s School of Dental Medicine’s Compliance Program in conjunction with the Compliance Director for company Medicine Health Sciences Schools and the Dean and other leaders at the School of Dental of Medicine. · Serve as a regulatory and policy and procedure resource, providing guidance to employees and management on dental school compliance issues and inquiries as needed, and research relevant regulations and communicate the need for policies and procedures and education. Collaborate with management for reasonable solutions with process improvements. Seek ongoing training and development to gain additional expertise in fulfilling the elements of an effective compliance program for the School of Dental Medicine. Maintain professional skills and knowledge through attendance at relevant conferences, seminars and other educational programs; participate in professional organizations, and review of current literature. Other duties or projects as assigned as appropriate to rank and departmental mission.

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