Director, Quality Assurance

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Dominion National at the time of posting and may be modified in the future. Dominion National offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.

Dominion National, a rapidly growing and leading provider of dental and vision benefits has an exciting opportunity for an experienced Director of Quality Assurance.

The Director of Quality Assurance is responsible for providing leadership and oversight of the operational activities and performance of the Credentialing, Utilization Management, Quality Assurance, and Fraud/Waste/Abuse programs. Responsibilities include but are not limited to maintaining overall responsibility of the appeals and grievances processes to ensure compliance with all applicable performance standards and regulatory, contractual, and corporate policies and procedures, driving the strategic planning and direction of assigned areas as well as overseeing staff development to meet the goals set for the respective department and organization.

Responsibilities And Qualifications

Essential functions include but are not limited to:

• Overseeing operational activities and performance of the organization’s Quality departments (i.e., Quality Assurance, Credentialing, and Appeals and Grievances).
• Serving as the leader for Quality operations to ensure full and consistent compliance with alliance partners, health plan contracts and regulatory requirements.
• Assisting management in developing action plans to improve quality measures while maintaining compliance in all activities.
• Driving the strategic planning, direction, and goal setting for the respective departments.
• Ensuring appeals & grievances, and credentialing processes meet or exceed regulatory and client expectations.
• Implementing regulatory updates related to all areas as prescribed by all regulatory agencies with direct oversight of Dominion’s Quality operations.
• Overseeing the management of the division’s operating budgets and holds direct reports accountable for meeting budget goals.
• Attending and participating in the Quality Assurance Committee meetings.
• Overseeing and directing compliance with all aspects of Dominion’s utilization management program and quality assurance policies.
• Working in close collaboration with various department heads in the administration of the quality assurance program.
• Performs other duties as assigned.
  
  

The Minimum Qualifications For The Ideal Candidate Include

• Bachelor’s degree business administration or closely related discipline, preferred.
• 8+ years management experience to include planning and evaluating department policies, processes, priorities, and performance goals.
• 8+ years of dental industry and/or managed care experience or similar processes in a related field preferred.
• Excellent interpersonal, communications and negotiation skills which include interacting well with employees and external contacts of all levels. Ability to deal with customers and business partners in a professional manner.
• Functional understanding of Total Quality Management concepts and data-based decision methods.
• Comprehensive knowledge of healthcare industry regulations and oversight, including its concepts, practices, and procedures.
• Demonstrated ability to work independently in a fast-paced environment and successfully prioritize competing tasks and demands.
• Ability to rely on extensive experience and judgment to plan and accomplish goals.
  
  

Dominion National is an equal opportunity employer. Applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color religion, national origin, disability, protected Veteran’s status, age or any other characteristic protected by law.