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Program Integrity Director Jobs in Michigan (NOW HIRING)

BHG LXXXIX LLC

Program Director

Mount Pleasant, MI

Program Director Behavioral Health Group (BHG) is the largest network of Joint Commission ... Sound judgment and high integrity * Effective and timely decision-making * Good at identifying ...

Baker College

Program Director- Nursing

Royal Oak, MI · On-site

As the Program Director of Nursing, you will serve as the driving force behind the academic ... You will cultivate a culture of compliance, collaboration, and integrity among faculty and students ...

Baker College

Program Director - Nursing

Royal Oak, MI · On-site

As the Program Director of Nursing, you will serve as the driving force behind the academic ... You will cultivate a culture of compliance, collaboration, and integrity among faculty and students ...

Baker College

Program Director - Nursing

Royal Oak, MI · On-site

As the Program Director of Nursing, you will serve as the driving force behind the academic ... You will cultivate a culture of compliance, collaboration, and integrity among faculty and students ...

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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.

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

Program Director

Behavioral Health Group

Mount Pleasant, MI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Program Director
Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited treatment centers and the leading provider of opioid addiction treatment services. We are dedicated to helping individuals overcome substance use disorders. With over 115 locations in 24 states, our team of more than 1,900 employees serves over 42,000 patients.
Job Summary
The Program Director oversees the daily operations of a treatment program, including the direct supervision of the treatment center's team members. This role ensures optimal performance in operations, staffing, training, compliance, and customer service. Key responsibilities include scheduling, supervising team members, facilitating training and professional development, overseeing the delivery of treatment services, evaluating patient progress, implementing company policies and procedures, and ensuring adherence to state, federal, and accrediting agency regulations. Additionally, the Program Manager will perform duties within the scope of their license or certification, as specified in an addendum to this job description.
Responsibilities:
  • Oversee patient admission, medication delivery, patient processing, chart preparation, and use of community resources.
  • Address complaints and grievances promptly.
  • Maintain high standards of the treatment center's infrastructure.
  • Handle urgent and emergent issues, even outside regular hours.
  • Regularly report on and improve treatment program performance.
  • Manage revenue collection and budgeted expenditures.
  • Ensure schedule adherence and minimize overtime.
  • Adhere to attendance standards and report work-related issues immediately.
  • Lead and mentor team members to achieve annual goals and objectives.
  • Enforce the agency's Code of Ethics and Conduct.
  • Execute and supervise comprehensive training programs.
  • Coordinate internal and external training and audits.
  • Moderate weekly team and intervention meetings.
  • Serve as the Corporate Compliance Officer.
  • Ensure team members are properly educated, credentialed, and licensed.
  • Maintain adequate staffing levels, manage recruitment, and address team morale and grievances.
  • Evaluate the performance of key leaders.
  • Manage hiring, termination, and unemployment claims with Human Resources.
  • Manage time off requests, timekeeping, and payroll approvals.
  • Ensure compliance with all regulatory and accrediting agency requirements and keep team members informed.

Qualifications:
  • Must hold a valid counseling license or certification, nursing license, Bachelors or Masters degree in the related Human services field.
  • Previous experience in an OTP setting is preferred but not required.
  • At least 3-5 years in an operational leadership role preferred but not required.
  • The ideal candidate is a technically competent leader with significant experience in the management of substance abuse treatment services across economically and culturally diverse communities.
  • Management experience should include responsibility for operations, compliance, safety, accreditation, and quality of care.
  • Must hold and maintain a valid driver's license.
  • In addition to meeting the qualifications, the ideal candidate will embody the following characteristics and possess the knowledge, skills and abilities listed below:
    • Advanced knowledge of medication assisted treatment
    • Excellent verbal and written communication skills
    • Sound judgment and high integrity
    • Effective and timely decision-making
    • Good at identifying issues, formulating long-term solutions, and solving problems
    • Demonstrated knowledge of ethical standards
    • Demonstrate basic computer/word processing skills

Physical Requirements and Working Conditions
  • Speaking and hearing ability sufficient to communicate effectively by phone or in person at normal volumes.
  • Vision adequate to read correspondence, computer screen, forms, etc.
  • Be able to sit for long periods of time, some bending, stooping and stretching.
  • Variable workload, periodic high stress and activity level
  • Interactions with patients who may be ill, have infectious diseases, have mental health diagnoses and/or are involved in the criminal justice system
  • Standard medical office conditions and environment
  • Keyboarding for long periods of time

Why BHG?
Join BHG, where your career flourishes in an environment built on teamwork and compassion. At BHG, we're not just a team; we're a family dedicated to patient well-being and professional growth. Here's why you should be part of our journey:
Work-Life Balance: Enjoy generous paid time off for vacation, holidays, and personal needs. Benefit from flexible schedules with early in/early out hours, no nights, and no Sundays, ensuring you have time for self-care and personal commitments. Manageable workload.
Investment in Your Growth: BHG prioritizes your development through role-based training and advancement opportunities. Grow with us as we nurture your career path.
Comprehensive Benefits: Choose from three robust benefits programs, including health, life, vision, and dental insurance. Enjoy our tuition reimbursement program and competitive 401K match, along with medical, dental, vision care, life insurance, disability coverage, and vacation time.
Recognition and Rewards: Experience competitive pay, quarterly bonuses, and incentives for completing certifications or licenses.
Employee Perks: Access exclusive discounts on various services and entertainment options. Take advantage of our Employee Assistance Program and self-care series.
At BHG, we thrive on the greatness of our people. Join us and become part of a community that values excellence, integrity, and making a real difference in the lives of others.
BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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