Texas Licensed Program Integrity DirectorVirtualVocations • Pueblo, Colorado, United States
Texas Licensed Program Integrity Director
VirtualVocations • Pueblo, Colorado, United States
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A company is looking for a Director of Program Integrity to lead the Program Integrity department focusing on claims editing and fraud prevention.
Key Responsibilities
Lead and oversee all Program Integrity operations
Design, analyze, and improve workflows to increase productivity and efficiency
Develop and implement internal controls ensuring compliance with laws and guidelines
Required Qualifications
5+ years management experience
8+ years' experience in Payment Integrity Audit and Recovery
2+ years' experience in a Managed Care health plan or state agency
Knowledge of ICD-10 and CPT / HCPCS coding guidelines
Certification / Registration / Licensure : Project Management or Six Sigma certification preferred
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Program Director • Pueblo, Colorado, United States
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