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Program Integrity Director Jobs in Michigan (NOW HIRING)

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 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 Michigan? For Program Integrity Director jobs in Michigan, the most frequently searched job titles are:
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

Beacon Specialized Living

Mount Pleasant, MI • On-site

$70K - $80K/yr

Per diem

Posted 7 days ago

Beacon Specialized Living rating

5.2

Company rating: 5.2 out of 10

Based on 42 frontline employees who took The Breakroom Quiz

196th of 238 rated social care providers

Job description

Position Summary:
The Program Director oversees assigned Beacon locations to ensure that company goals, budgets, and clinical effectiveness targets are met. They support Care Team Managers by ensuring adequate staffing and resources for high-quality care, and keep department heads informed of staffing, compliance, and operational concerns. The Program Director plans and co-chairs monthly staff meetings, ensuring that agendas are coordinated, and documentation is filed.
They also ensure the consistent application of policies and procedures, monitor Care Team Managers' workload, and review incident reports for timely submission to regulatory agencies. The Program Director communicates with regulatory agencies, assists the compliance department with corrective action plans, and manages Census, payroll costs, and EBITDA targets.
Additionally, they ensure accurate time-and-attendance reporting, manage staffing needs, and oversee new employee orientation and training compliance. The Program Director addresses personnel issues with HR, Compliance, and Executive Leadership, provides feedback on performance reviews, and manages the DSP leveling program.
The Program Director ensures individual protection, personal care, and participation in skill-building activities, maintains accurate records, and performs ongoing audits of Beacon location(s) operations.
Responsibilities/Essential Functions:
Integrity
  • Always be compliant with all company and regulatory policies and procedures.
  • Operational Oversight: Ensure that company goals, including budget and clinical effectiveness targets, are met.
  • Policy Implementation: Consistently apply and deploy BSLS policies, procedures, and care practices.
  • Incident Reports: Review incident reports, submit them for approval, and ensure timely submission to regulatory agencies.
  • Work Injury Reports: Ensure work injury reports are entered accurately and in a timely manner if needed.
  • Record Maintenance: Ensure records are secure, confidential, up-to-date, and accurate for individuals and employees.
  • Reporting Requirements: Ensure that reporting requirements are met and monitor various plans and quality.
  • Ongoing Audits: Perform ongoing audits of location operations, including routine inspections.

  • Must fully cooperate with all licensing reviews and internal or external investigations

Compassion
  • Supervision: Support and supervise Care Team Managers to ensure adequate staffing and resources for high-quality care.
  • Personal Care Logs/Daily Documentation: Ensure that logs are completed correctly and in a timely manner.
  • EMAR/MAR: Ensure accuracy in medication administration records.
  • Individual Protection: Ensure individual protection, personal care, and adherence to clinical actions.
  • Skill-Building Activities: Ensure individuals participate in skill-building and community activities.
  • Individual Interaction: Attend individual functions and maintain regular interaction.
  • Individual Assessments: Assist with individual assessments, placement, transfers, and discharges.

Advocacy
  • Communication: Keep department heads informed of staffing, compliance, and operational concerns; collaborate with leadership.
  • Licensing Liaison: Communicate with licensing consultants and external agencies to resolve issues.
  • Investigation Response: Lead responses to investigations and facilitate access to requested information.
  • Compliance Assistance: Assist the compliance department with responses, correspondence, and corrective action plans (CAPs).
  • Personnel Issues: Address personnel issues with HR, Compliance, and Executive Leadership.
  • Advocacy for Staff: Assist staff with navigating the process for training and tuition reimbursement.

Respect
  • Meetings: Plan, attend, and co-chair monthly staff meetings, coordinating agendas and ensuring documentation is filed.
  • New Employee Orientation: Ensure new employee orientation is completed and monitored.
  • Staffing Management: Collaborate with Care Team Managers, Recruiters, and Trainers to achieve full staffing.
  • Training Compliance: Enforce training compliance and provide monthly reports.
  • Personnel Issues: Address personnel issues with HR, Compliance, and Executive Leadership.
  • Respect for Individuals: Ensure proper clinical actions are taken to maintain or improve individual health, safety, and stability.

Excellence
  • Financial Management: Manage Census, LOA's, Per Diem Rates, payroll costs, and EBITDA targets.
  • Budget Monitoring: Support Care Team Managers with financial plans/budgets and ensure understanding of budgetary reporting.
  • Time-and-Attendance: Ensure accurate reporting by monitoring schedules and actual time worked.

  • Staffing Needs: Manage staffing needs, interviewing, placement, and training of Care Team Managers.
  • Performance Reviews: Provide feedback to Care Team Managers on semi-annual performance reviews.
  • DSP Leveling Program: Manage DSP leveling program and promote it in assigned locations.
  • Program Improvement: Identify ways to improve programs to enrich individuals' needs and involvement.
  • Five Diamond Status: Support the Care Team Manager in all areas to achieve 5 diamond status

Performance and Evaluation:
In addition to evaluating your work performance you will be evaluated for the following work behaviors:
    • Job Knowledge - Depth and breadth of knowledge supporting our organization goals
    • Quality of Work - Freedom from errors and mistakes, timeliness, accuracy and overall work quality
    • Quantity of Work - The amount of work output from the employee
    • Reliability - The extent to which the employee can be dependent upon to be available for work. This includes being reliable, trustworthy and persistent
    • Initiative and Creativity- The ability to plan work and proceed with tasks without detailed instruction as well as the ability to make constructive suggestions
    • Judgement- The extent to which the employee makes sound decisions based on fact rather than emotion.
    • Cooperation - Willingness to work harmoniously with others to complete tasks and respond positively
    • Attendance - Faithfulness in coming to work daily and adhering to scheduled work hours.
    • Planning and organizing - The ability to analyze work, set goals, develop action plans, utilize time efficiently and delegate work appropriately
    • Directing and Controlling - The ability to create a motivating climate, achieve teamwork, train and develop employees, measure work progress and take corrective action
    • Decision Making - The ability to make quality timely decisions
    • Problem Solving - The ability to assess a problem, identify solutions, formulate plans, execute those plans, and achieve positive outcomes consistently
    • Embracing, supporting and adhering to Beacon's mission and Core Values

Education and Qualifications:
    • Bachelor's degree in human service preferred
    • Minimum of two (2) years' experience of previous management or supervisory experience in

a residential care environment
    • Effective oral and written communication skills
    • Strong computer skills and the ability to use office equipment including any BSLS systems
    • Attention to detail and ability to multitask
    • Must possess a valid driver's license
    • Proficient in reading and writing the English language
    • Approved by state, federal and government entities to work within BSLS programs

Physical Demands and Work Environment:
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform essential functions.
Physical Demands:
  • While performing the duties of the job, the employee must be able to move about the Beacon location or community 50% of the time and can bend, squat, stand, kneel, push, pull, walk, and reach above shoulder height. Employees must be able to remain in a stationary position 50% of the time.
  • Ability to lift and carry objects up to 50 pounds for short distances (5-10 feet) daily.
  • The employee will climb approximately 8-12 stairs 8-10 times per day.
  • The employees will operate a computer and other office productivity machinery, such as a copy machine and computer printer. Ability to access, input, and retrieve information from the computer and use information technology systems as noted above.
  • The employee must be able to prepare meals which require the use of an oven, stove, or microwave that may require overhead reaching.
  • Complete laundry services that include sorting, washing/drying, and folding. May be required to carry loads of laundry up and down approximately 8-12 stairs.
  • Grocery shopping that includes driving to the grocery store daily to grocery shop, carrying full grocery bags up and down stairs (approximately 8-12), and reaching and stooping to put away groceries.
  • The employee will perform cleaning activities, which include mopping, sweeping, and vacuuming that require regular lifting, turning, bending, and reaching.
  • Provision of personal care to individuals served, transferring individuals from bed to chair, chair to standing, sit to standing that requires the strength to assist lifting up to a 250-pound individual.
  • Constantly communicate and exchanges information with team members.
  • Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus to compare and distinguish administrative data and figures. Ability to make general visual observations of facilities or

structures, for safety inspections and hazard identification.
  • Hearing ability to perceive the nature of sounds at a normal speaking level with or without correction. Ability to receive detailed information through oral communication, and to make discriminations in sound.
  • Dexterity of hands and fine finger movements for medication distribution, manual dexterity to handle objects.
  • Proficiency in speaking, reading, and writing the English language is required.
  • Ability to effectively perform verbal and physical interventions recommended by the Crisis Intervention System.

Work Environment:
  • This is a full-time on-site position requiring regular rotation between Beacon locations within the assigned caseload.
  • While performing the duties of this job, the employee regularly works in a typical home setting or in the community at various stores, restaurants, entertainment venues, etc. Work may involve the treatment of non-cooperative individuals with psychosocial problems and needs, or chronic and acute health problems.
  • In addition, you may have the potential for exposure to infectious disease and physical and verbally aggressive behaviors. Universal precautions are required to minimize the risk of infections.
  • Work sites may include locations that are not barrier-free. Duties are performed in an environment where there is a potential for physical aggression from individuals.
  • The work environment presents situations that cause stress and anxiety due to individual behavior.
  • The noise level in the work environment is usually moderate.
  • The employee may be exposed to cold, heat, dust, or smoke.

Travel:
This position requires up to 80% of day travel.
AAP/EEO Statement:
It is the policy of Beacon to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, marital status, status with regard to public
assistance, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Beacon will provide reasonable accommodation for qualified individuals with disabilities.
As an employee of Beacon Specialized Living (BSLS), you understand and acknowledge that BSLS provides care for individuals living in a residential setting that operates 24 hours, 7 days a week at multiple
Beacon locations, and that you may be scheduled to work at any time or day of the week, including holidays, and that you may be assigned to work at different locations as needed. You understand and acknowledge that BSLS reserves the right to reassign you to work at any of its Beacon locations if
necessary.
This job description is intended to describe the nature and level of work required by the person assigned this classification. It is not an exhaustive list of all duties and responsibilities. Other job duties and responsibilities may be assigned by the employer at the employer's sole discretion. This job description may be amended at any time by the employer.
The employee's signature below constitutes the employee's understanding of the requirements, responsibilities, and duties of the position.

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