Clinic Compliance Manager

Tufts University School of Dental Medicine (TUSDM) offers one of the most forwardlooking educational environments in dental medicine and maintains a Compliance Program focused on meeting federal, state, and accreditation requirements, including AntiKickback, Fraud and Abuse, and HIPAA Privacy and Security regulations.

The TUSDM Compliance Program is an evolving function that continues to strengthen audit oversight, adapt to a dynamic regulatory environment, and establish consistent, bestpractice compliance processes across clinical and academic operations. The Clinic Compliance Manager plays a key role in this effort by bringing experience, insight, and a riskbased perspective to help advance and sustain effective audit and compliance practices.

This position reports to the Senior Compliance Officer and works closely with the Revenue Cycle Department, Clinic Administration (Clinical Affairs), PostGraduate Practice Managers, and billing, clinic, and academic management teams.

This is a hybrid, parttime (24 hours per week; approximately 0.68 FTE), benefitseligible position, with onsite presence required as needed to support clinical and operational needs. The posted compensation range reflects a fulltime (35hour) workweek and will be prorated accordingly.

As a core member of a small and evolving Compliance Team, the Clinic Compliance Manager partners closely with the Senior Compliance Officer to help build, implement, and advance audit and compliance practices across Tufts University School of Dental Medicine (TUSDM). The role develops, executes, and oversees Compliance Audit Work Plans for the PreDoctoral and PostGraduate Clinics, with an emphasis on independent audit review, risk assessment, and bestpractice application rather than daytoday billing operations.

The Clinic Compliance Manager conducts routine compliance audits of the dental clinics to assess medical necessity and appropriate levels of care billed, in accordance with Medicare, Medicaid, other federal insurance programs, and thirdparty payer requirements. This position brings experience and judgment to an evolving environment, helping to establish consistent audit approaches and translate regulatory requirements into practical, sustainable compliance processes.

The role provides guidance, education, and training and recommends corrective action plans, as appropriate, to members of the TUSDM workforce, including students, residents, fellows, faculty, staff, volunteers, and TUSDMsponsored visitors. The Clinic Compliance Manager collaborates closely with Clinical Affairs, Practice Managers, the TUSDM Billing Department, and external entities to identify risk, interpret regulatory guidance, and support continuous improvement across clinical, academic, and revenuecycle operations.

Key responsibilities include:

• Conduct accurate and compliant reviews of medical and dental records and provider services to identify audit findings, compliance risks, and opportunities for coding education; develop and recommend corrective action plans to address instances of noncompliance.
• Partner with the Senior Compliance Officer to help establish, refine, and maintain audit processes, work plans, and best practices appropriate for a growing compliance program.
• Formulate and update, at least annually, billing guidelines and policies related to professional fee billing for both medical and dental services, informed by audit results and regulatory requirements.
• Monitor pre and postbilling compliance and assist in mitigating identified risk areas through audits and other riskassessment techniques; analyze findings and make recommendations to strengthen controls and processes.
• Prepare clear, welldocumented audit reports outlining findings, trends, and recommendations; compile and maintain audit results within the audit database.
• Develop and deliver training materials and educational programs related to coding, documentation, and billing compliance for providers and clinical and administrative staff, including independent contractors.
• Participate in TUSDM meetings and provide ongoing education and guidance on coding and auditrelated topics to students, faculty, staff, and workforce members.
• Coordinate and manage requests, inquiries, or investigations from regulatory agencies and thirdparty payers, working closely with internal stakeholders as needed.
• Perform additional duties and special projects as assigned to support the continued development and effectiveness of the Compliance Program.