POSITION OBJECTIVE

The Director of Patient Services will contribute to the quality assurance programs by implementing policy and procedures that support the needs of the patients of the School of Dental Medicine. The primary accountability will be to maintain compliance with the American Dental Association accreditations standards and federal and state regulations. The director of Patient Services is an entity unto itself and collaborates with the clinical faculty to ensure the operational standards are in compliance with the School of Dental Medicine’s clinical care. Working as the first-line ombudsman for patient complaints and concerns, the director will sign dental records for refunds and adjustments and commit the school to remediation of patient treatment ordered by attending doctors. The director is responsible for maintaining the controlled substances logs, accessing the schools controlled substances locker when necessary and dispensing controlled substances to residency programs approved for use. The Assistant Dean for Clinical Affairs will supervise activities involving patient records, on site reviews and support the director with the protocols regarding risk mitigation and HIPAA compliance.

ESSENTIAL FUNCTIONS

1. Respond to patient comments, complaints, grievances and appeals generated by phone, walk-in, or correspondence. Summarize the complaint, update the database and determine strategies needed to resolve the complaint. Provide thorough documentation of inquiries and resulting correspondence. Coordinate with other departments as required to obtain inquiry resolution within specified timeframes. Request financial adjustments approved by the Assistant Dean for Clinical Affairs. There are approximately 750 grievances/appeals per year of which 60% are uncomplicated and 40% are complicated which require professional intervention and adjudication by appropriate resources. All of the cases of a complicated (40%) nature are digitally fully documented and all the uncomplicated 60% are digitally listed as part of the database and resolved by the Director of Patient Services. Examples not limited to dismissal for broken appointments, unpaid residual balances, etc. Serve as a resource advocate to patients, students and residents. Maintain accurate and well documented logs and databases of dental record audits and (those that involve employee’s performance records). (45%)
2. Prepare teaching materials for students and residents relating to risk mitigation both in the School of Dental Medicine and their future practices. Ensure course materials are current for the succeeding academic session. (10%)
3. Responsible for monitoring applicable regulations in congruence with the University Compliance Office, the Office of General Counsel (e.g., HIPAA, FERPA) and [U]Tech in order to ensure school-wide compliance. Serve on the University Compliance Committee as needed and work with these offices in obtaining relevant records and statements (patient, faculty and student). (10%)
4. Monitor/maintain compliance in the dispensation of controlled substances, in conjunction with the Office of the Associate Dean for Administration. Provide reports on quality assurance matters to the Dean of the School of Dental Medicine or their designee, such as, summary data of patient complaints, and threats of litigation. (10%)
5. Facilitate the development, implementation and maintenance of systems that promote desirable patient outcomes through standardization of processes and implementation of strategic plans of best practices, cost-saving initiatives and patient safety strategies. Examples would include but not limited to breaches in the standard of care, the mishandling of patient digital records and other deviations in quality assurance protocol. Facilitation essentially encompasses assisting patients in their concerns and to help them to be comfortable with their care and the School of Dental Medicine. (5%)
6. Provide faculty with input/feedback that changes management efforts to improve clinical performance in health care outcomes and compliance and transform that data into comparative analysis to inform teaching and clinical practices that support quality assurance functions. (5%)
7. In coordination with Dental School administration, provide the leadership necessary to successfully sustain student and patient related clinical activities in the pre-and post-doctoral programs. This includes issues that may pertain to the clinical program, the review of student and resident participation and performance within their respective clinical areas and collaboration with staff and attending faculty members to ensure coordination between academic programs and treatment centers. (5%)
8. Develop systems that identify non-conformance with compliance standards, assess associated risk and recommend corrective measures. Collaborate with senior administration to create a culture that promotes compliance in manner that is pragmatic and patient-centered. (5%)
9. Draft clinic policies and procedures and maintain written and online clinic manuals. Collect and provide information to the Assistant Dean for Clinical Affairs regarding adverse outcomes and avoidable mistakes. Summarize information and write first draft of clinic policies and procedures. Proof additional drafts. (5%)

NONESSENTIAL FUNCTIONS

Perform other assignments as instructed. (<1%)

CONTACTS

Department: Periodic contact as needed with Director of Quality Assurance to provide information. School: Occasional contact with the Clinical Assistant Dean and the auditing supervisor to resolve complaints. Moderate contact with faculty and staff including (Office of Development and Alumni Relations) and the Assistant Dean for Clinical Affairs to resolve complaints.

University: Contact as needed with the Office of General Counsel, [U] Tech and Compliance Office to resolve complaints.

External: Daily contact with patients to resolve complaints. Occasional contact with local hospitals, clinics and private dental offices to obtain/provide information. Some contact with the university Police Department to obtain/provide information.

Students: Daily contact with students, residents and fellows to resolve complaints.

SUPERVISORY RESPONSIBILITY

Direct supervision of student office assistants regarding patient information security.

QUALIFICATIONS

Experience: 4 or more years of related experience required. Experience in customer service or member relations experience in insurance or managed care environment required. Experience with standards regulation, contract compliance and quality assurance preferred.

Education/Licensing: Bachelor’s degree required; graduate degree preferred.

REQUIRED SKILLS

1. Demonstrated knowledge of ADA-CDT, AMA-CPT codes and CBOHR.
2. Demonstrated knowledge of dental and dentally related medical terminology.
3. Working knowledge of computers and specifically Microsoft Word, Excel and Access.
4. Professional demeanor and ability to work with minimal supervision, evaluate, plan and implement effectively.
5. Ability to deal with diverse populations including but not limited to multi-cultural patients, faculty, students, internal and external staff.
6. Excellent oral, written, listening and organizational skills.
7. Ability to work collaboratively with others. Ability to resolve difficulties quickly, make decisions and institute change.
8. Strong attention to detail. Self-motivated. Analytical skills for problem identification and resolution.
9. Ability to meet consistent attendance.
10. Ability to interact with colleagues, supervisors and customers face to face.

WORKING CONDITIONS

Very busy office atmosphere. Minimal hazard exposure: vaccination for Hepatitis B is required (provided by the university). Frequent circulation to the dental clinics, residency programs and faculty offices within the School of Dental Medicine will be required. Dress is business casual and professional appearance is mandatory. To promote safety, employees are expected to exercise caution and comply with safety regulations and university policies/procedures when involved in the following conditions: exposure to blood borne pathogens and communicable diseases and interactions with aggressive, disruptive and/or unruly individuals. This position will involve the dispensing and monitoring of controlled substances.