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Program Integrity Director Jobs in Maine (NOW HIRING)

Sofive

Youth Program Lead Coordinator

Saco, ME · On-site

Integrity is the backbone of our organization. We value reliability and professionalism in our ... Prior sales experience in a direct-to-consumer retail environment a bonus. * Prior experience as a ...

Skillcloud HCM

Director of Finance

Portland, ME · On-site

$90K - $95K/yr

... integrity, credibility, and dedication to the mission of ProsperityME. * Ability to translate ... Excellent experience with financial programs and software including QuickBooks Benefits of the Job:

Skillcloud HCM

Director of Finance

Portland, ME

$90K - $95K/yr

... integrity, credibility, and dedication to the mission of ProsperityME. * Ability to translate ... Excellent experience with financial programs and software including QuickBooks Benefits of the Job:

Habitat For Humanity

Executive Director

Bath, ME · On-site

$65K - $85K/yr

The ED advances the mission through effective program oversight, innovative fundraising, careful ... The successful candidate will embody Habitat's core values of integrity, respect, compassion, and ...

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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 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 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 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 job categories do people searching Program Integrity Director jobs in Maine look for? The top searched job categories for Program Integrity Director jobs in Maine are:
What cities in Maine are hiring for Program Integrity Director jobs? Cities in Maine with the most Program Integrity Director job openings:
Program Integrity Director jobs near you

Director of Social Services

Covenant Health

Biddeford, ME

Full-time

Posted 6 days ago

Job description

Director of Social Services - Lead with Heart, Drive with Excellence!

St. Andre Health Care - Biddeford, ME

CHAMPION WELL-BEING. LEAD WITH PURPOSE.

Are you a visionary Social Services leader ready to make a profound impact on the lives of seniors? At St. Andre Health Care, we believe that true healing and comfort go far beyond medical care-they are rooted in dignity, advocacy, and emotional support.

We are seeking a dynamic, mission-driven Director of Social Services to lead our psychosocial programs for our 80-resident community. This is more than a management role; it's an opportunity to be the heart of our facility, ensuring every resident feels heard, valued, and at home.

WHY CHOOSE ST. ANDRE HEALTH CARE?

  • Mission-Driven Leadership: Join a faith-based organization within the Covenant Health network where your work is guided by values of compassion and integrity.

  • Direct Impact: As a key member of the leadership team, you will have a direct hand in shaping the resident experience and enhancing their quality of life.

  • Collaborative Culture: Work in an environment where the Interdisciplinary Team (IDT) truly partners together, valuing each other's expertise.

  • Supportive Infrastructure: Benefit from a strong regulatory and compliance framework that allows you to focus on process improvement and clinical excellence.

THE OPPORTUNITY

  • Status: Full-Time

  • Schedule: Monday - Friday (Enjoy a consistent leadership schedule!)

  • Impact: Oversee psychosocial services for approximately 80 residents.

  • Reports To: Administrator

YOUR MISSION: ADVOCACY & EXCELLENCE

In this pivotal role, you will partner closely with the Administrator and the IDT to lead a resident-centered social services department.

Key Responsibilities:

  • Lead & Oversee: Direct all psychosocial services, ensuring they meet the highest standards of care and resident satisfaction.

  • Collaborate: Play an active role in the Interdisciplinary Team (IDT) to develop holistic, person-centered care plans.

  • Regulatory Champion: Ensure all services remain compliant with Federal and Maine state regulations, maintaining our reputation for excellence.

  • Advocate: Serve as a primary resource for residents and their families, providing support during transitions and navigating the complexities of long-term care.

  • Innovate: Identify opportunities for process improvement to constantly elevate the level of service provided to our community.

READY TO LEAD A NEW CHAPTER?

If you are a compassionate leader who thrives in a collaborative, process-improvement-focused environment, we want to hear from you.

Apply today to join the St. Andre Health Care family and lead our Social Services team toward excellence!

***The rate of pay displayed reflects the beginning of the pay scale. At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.***

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