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Program Integrity Director Jobs in Iowa (NOW HIRING)

The Director of Bachelor of Science in Pharmacy Sciences (BSPS) Program serves as the inaugural ... integrity, and program quality. * Oversee the implementation and consistent application of BSPS ...

As the Program Management Bureau Director, your duties will include, but are not limited to ... Safety First, People Matter, Customer Focused, Servant Leadership, and Integrity Without Exception.

Respond to clinical crises according to facility policy, ensuring safety and program integrity ... Requires standing, walking, and direct patient interaction. * Shifts may include evenings, weekends ...

Integrity is one of the nation's leading independent distributors of life, health and wealth ... This role ensures program accuracy, consistency, and effectiveness across all internal and external ...

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Program Integrity Director information

What are the key skills and qualifications needed to thrive as a Program Integrity Director, and why are they important?

To thrive as a Program Integrity Director, you need expertise in compliance, risk management, regulatory analysis, and a relevant degree such as in business administration, public policy, or law. Familiarity with data analytics tools, case management systems, and certifications like Certified Fraud Examiner (CFE) or Certified Internal Auditor (CIA) are often important. Strong leadership, ethical judgment, and effective communication skills are crucial for building trust and guiding teams through complex investigations. These skills ensure the organization maintains regulatory compliance, prevents fraud, and promotes operational transparency.

What is the difference between Program Integrity Director vs Claims Manager?

AspectProgram Integrity DirectorClaims Manager
Required CredentialsBachelor's degree, certifications in healthcare compliance or auditingBachelor's degree, experience in claims processing or insurance
Work EnvironmentHealthcare or insurance organizations, compliance departmentsInsurance companies, healthcare payers, claims processing units
Employer & Industry UsageUsed in healthcare, government programs, insurance sectorsPrimarily in insurance companies and healthcare payers

The Program Integrity Director focuses on ensuring compliance, preventing fraud, and maintaining program integrity within healthcare or insurance organizations. In contrast, Claims Managers oversee the processing and adjudication of insurance claims. While both roles require knowledge of healthcare or insurance operations, the Program Integrity Director emphasizes compliance and fraud prevention, whereas the Claims Manager concentrates on claims processing efficiency and accuracy.

What are Program Integrity Directors?

Program Integrity Directors are responsible for overseeing and ensuring the compliance, effectiveness, and accountability of organizational programs, often within government agencies or large organizations. They develop and implement policies to prevent fraud, waste, and abuse, and they monitor program operations to ensure adherence to regulations and standards. Program Integrity Directors often lead teams, conduct audits, and collaborate with other departments to promote transparency and ethical practices. Their work is crucial for maintaining public trust and ensuring resources are used appropriately.

What are some typical challenges faced by a Program Integrity Director, and how can they be addressed?

Program Integrity Directors often face challenges such as navigating complex regulatory requirements, detecting and preventing fraud, and ensuring compliance across multiple departments or partners. Addressing these requires strong analytical skills, clear communication, and effective collaboration with legal, compliance, and operational teams. Staying updated on industry best practices and fostering a culture of transparency can also help mitigate risks and support program goals.
What are popular job titles related to Program Integrity Director jobs in Iowa? For Program Integrity Director jobs in Iowa, the most frequently searched job titles are:
What cities in Iowa are hiring for Program Integrity Director jobs? Cities in Iowa with the most Program Integrity Director job openings:
Integrity & Compliance Program Manager

Integrity & Compliance Program Manager

Trinity Health

Waterloo, IA

Full-time

Posted 25 days ago


Trinity Health rating

6.5

Company rating: 6.5 out of 10

Based on 353 frontline employees who took The Breakroom Quiz

607th of 886 rated healthcare providers


Job description

Employment Type:Full timeShift:Description:Job Description Summary
Accountable for leading, guiding, and directing the Trinity Health ministry or enterprise functional responsibilities. Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues; provide functional expertise and ensure fulfillment of performance and service standards. Responsible for consistent operating performance and achieving financial goals. Identifies, defines & solves complex problems that impact the management & direction of the business; Collaborates with System Services Areas, Regions, and Health Ministries to ensure consistency and integration of strategy and operations. Maintaining awareness of new industry developments and standards. Provides decision support, operations &/or optimization leadership focus.
** Position is located in Iowa.
**Candidates that are local to Iowa would work on site and travel to other locations as needed.

Functional Role (not inclusive of titles or advancement career progression)

Assist the Integrity and Compliance Director with guiding and managing the complianceactivities andinitiativesfor assigned ministry(ies).Provides advice,guidanceand program management to ministry leaders in developing,implementingandattainingprogram goalswhile ensuringalignment tocompliance strategies.Conducts investigations for local ministryand provides recommended action in response to outcome of investigation.Participatesin Service Area and Enterprise Integrity and Compliance projects with a focus on standardization and process improvements.

  • Support the Integrity and Compliance Director in developing, executing, and overseeing compliance initiatives within the ministry.

  • Provide expert advice and strategic guidance to ministry leaders on program goals and compliance strategies.

  • Lead and conduct internal investigations related to compliance concerns, ensuring thorough,timely, and objective outcomes.

  • Deliver well-documented recommendations for corrective actions based on investigative findings.

  • Partner with leaders across local ministries and enterprise functions to implement and sustain compliance strategies.

  • Activelyparticipatein Service Area and Enterprise-level compliance projects, focusing on process improvement and standardization.

  • Collaborate on the development and rollout of organization-wide policies, training, and communication tools to foster a culture of ethics and compliance.

  • Monitor emerging risk areas and regulatory changes, ensuring proactive andappropriate organizationalresponse.

  • Contribute to audit readiness activities and help strengthen internal controls across the ministry.

  • Track compliance performance metrics and support continuous improvement initiatives to enhance overall program effectiveness.

Minimum Qualifications

Bachelor'slevel degree in business,health administration,or arelated field, a law degree, or an equivalent combination of education & experience.

Minimum of five 5 years of relevant experience with increasing levels of responsibility in health care compliance &/or consulting including regulatory compliance, program metrics, performance assessment, & reporting outcomes, etc.

Mustpossessa thorough understanding and knowledge of health care legal and regulatory practices, financial and internal control systems/procedures.

Previousproject, program,supervisoryor management experience.

Additional Qualifications (nice to have)

Experience within a health care organization (including ambulatory and hospital settings) or equivalent workexperienceinvolving clinical documentation and coding reviewsand working knowledge ofConditions of Payment includinggovernmentandthird- party payer regulations.Mustunderstand and haveexpertisewith Patient Driven Payment Models, Patient Driven Groupings Models, IRF-PAI and OASIS requirements.Comprehensive understanding of Medicare Physician Fee Schedule and Medicare Claims Processing Manual for professional services..Comprehensive understanding of Conditions of Participation and Accreditation Standards.

CHC, CHPC, CHRC, CCEP or equivalent certification.

Lean/Six Sigma training and/or certification

.

Physical & Mental Requirements & WorkingConditions (General Summary)

Direct Healthcare Services / Indirect Healthcare / Support Services:

  • Exposure to conditions which may be considered unpleasant to sight, touch, sound& /or smell.Occasional

  • Exposure to fumes, odors,dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.).Occasional

  • Exposure to or subject to noise, infectious waste, diseases & conditions.Occasional

  • Exposure to interruptions, shiftingpriorities& stressfulsituations.Frequent

  • Ability to follow tasksthrough tocompletion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens overlong periodsof time & work on concurrent tasks / projects.Frequent

  • Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person& /or over the phone / computer / device / equipment assigned) with some background noise.Frequent

  • Perform manual dexterity activities & / or grasping / handling.Continuous

  • Ability to climb, kneel,crouch & /oroperatefoot controls.Occasional

  • Use a computer / other technology.Frequent

  • Sit with the ability to vary / adjust physical position or activity.Frequent

  • Maintain a safe working environment & use available personal protective equipment (PPE).Continuous

  • Comply withTrinity Health's Code of Conduct, policies, procedures & guidelines.Continuous

  • Ability toprovide assistancein the event of an emergency.Occasional

Direct Healthcare Services:

  • Perform activities that require standing / walking with the ability to vary / adjust physical position or activity.Occasional

  • Lift a maximum of 30 pounds unassisted. Occasional

  • Use upper & lower extremities, engage in bending / stooping /reaching& pushing / pulling. Occasional

  • Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions.Continuous

  • Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions.Occasional

  • Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients).Occasional

Indirect Healthcare / Support Services:

  • Perform activities that require standing / walking with the ability to vary / adjust physical position or activity.Occasional

  • Lift a maximum of 30 pounds unassisted.Occasional

  • Experience oflong periodsof walking / standing / stooping / bending / pulling & / or pushing.Occasional

  • Encounter a clinical / patient facing / hands on interactive work environment.Occasional

  • Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions.Continuous

  • Work outdoors with variable external environmental conditions.Occasional

  • Hourly pay ranges: $47.23 - $70.85

Average Workday Activity: Occasional - O (1% - 33%), Frequent - F (34% - 66%), Continuous - C (67% - 100%)

Hourly pay range: $47.23 - $70.85

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.


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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US