Director of Program Integrity

Overview

Our client is seeking a Director of Program Integrity to lead and oversee operations focused on claims editing, fraud prevention, and payment accuracy. This role is essential for ensuring operational excellence and adherence to regulations. Key Responsibilities ● Identifies and analyzes the design of jobs, work processes, work flows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency. ● Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops and reading professional journals. ● Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. ● Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives. ● Develops, implements, monitors, and revises annual goals and objectives for the department. ● Selects, trains, schedules, motivates, supervises, and evaluates employees. Schedule and Shift Details ● Will have to be onsite at least SIX DAYS a month.

Qualifications

• Bachelor's degree or higher
• Managed Care (2+ years)
• 1+ years of experience in ANY of the following:
  • ICD10
  • Medical Coding
• Medicaid (1+ years)
• ANY of the following valid licenses/certifications:
  • Lean Six Sigma
  • Project Management Professional (PMP)

Benefits

Company

When you embark on a career with our client, you join a team of engaged employees driving great service and excellence in patient care. You have the opportunity to apply your skills and advance your career goals. We blend cultures, talents and experiences into an exemplary health and hospital system. As the public hospital for Dallas, this client has been providing exceptional care stretches back for over a century. Today, many of the client's specialty areas have garnered national achievements in care, research, and technological innovation. Every step of the way, our talented professionals have maintained the highest standards of service and performance, recognizing the intrinsic worth of each patient and the importance of every interaction. We understand that the people are the key to our success, and we support our employees with the tools and resources they need to excel. We’ve created a collaborative work environment where respect, authenticity, and transparency are valued.