Dental Director - Fraud and Waste

Responsibilities

• Conduct clinical reviews to assess care quality for members
• Review dental claims for fraud, waste, and abuse investigations
• Stay updated on dental standards and develop new data tools
• Coincoperate investigations with law enforcement and compile evidence
• Perform on-site audits of billing practices of providers
• Prepare detailed investigative and audit reports for executive strategy
• Advise on functional strategies concerning fraud and abuse matters

Qualifications

• Doctor of Dental Surgery (DDS) or DMD degree required
• Minimum five years of clinical experience as a practicing dentist
• Active dental license in any US state is mandatory
• Proficient in data analysis and report interpretation
• Strong computer skills including MS Office applications
• Excellent written communication skills
• Understanding of workflow and process concepts