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Program Integrity Director Jobs in Minnesota (NOW HIRING)

Newport Healthcare

Clinical Director

Saint Cloud, MN · On-site

$79K - $108K/yr

The Clinical Director is responsible for fulfillment of essential duties, whether directly or ... Upholds the integrity of the program and fidelity to the clinical model, by taking a higher-level ...

Newport Healthcare

Clinical Director

Saint Cloud, MN

$79K - $108K/yr

The Clinical Director is responsible for fulfillment of essential duties, whether directly or ... Upholds the integrity of the program and fidelity to the clinical model, by taking a higher-level ...

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

Program Director, Full Time, Hazelwood Home, Mankato, MN

Prairie Community Services, Inc.

Mankato, MN • On-site

$58K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 17 days ago

Prairie Community Services rating

6.4

Company rating: 6.4 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

About the job: As a Program Director, you are responsible for all aspects of our 24-hour operation of program serving people with intellectual/developmental disabilities, brain injuries, challenging behaviors and/or mental health needs. This includes supervision and training of staff, ensuring coordination and execution of person-centered programming and positive support services for people served, day to day coordination of program, maintaining records and ensuring compliance with regulatory agencies. Starting salary is $58,240.
Essential job responsibilities include, but not limited to:
  • Develop, implement, evaluate, update, and train on each person's services, supports, and outcomes.
  • Ensure the needs and program expectations of persons served are met 24 hours/day.
  • Follow recipes, menus and diets as ordered when preparing and serving meals/snacks.
  • Ensure medical treatments and medications are ordered, secured, stored, documented, and given as medically ordered.
  • Communicate professionally and courteously with people we serve and their family members, outside services and providers, all PCS staff, and the public.
  • Develop and maintain staff schedules including approving/denying staff requests for time off.
  • Ensure documentation of daily program information.
  • Attend and/or lead all in-services, develop and maintain staff schedules complete employee performance reviews, hire discipline and terminate staff.

Qualifications:
  • Must be 18 years of age or as dictated by licensure.
  • Must pass DHS background clearance.
  • Must have valid driver's license and meet company driving criteria.
  • Must be able to read, write, communicate and understand the English language while conducting company business.
  • Must have a BA or BS degree in human services or a related field.
  • Experience working with a mental health diagnosis

Benefits That Support You:
  • Your well-being matters to us. That's why we provide exempt-level team members flexible paid time away-designed to give you the time you need, when you need it most, without worrying about accruals or tracking.
  • Comprehensive Health Coverage - 100% employer-paid employee health insurance, with access to spouse and family plans.
  • Health Savings Account Contributions - $150 per month toward your HSA when enrolled in our insurance.
  • Peace of Mind - $20,000 employer-sponsored life insurance. Plus, access to an additional voluntary plan.
  • Retirement Readiness - Strong retirement plan options with employer contributions, plus financial education resources to help you prepare for whatever life brings.
  • Additional Voluntary Benefits - dental, vision, hospital indemnity, critical illness, short- and long-term disability (STD/LTD), and accident insurance to fit your individual and family needs.
  • Employee Assistance Program (EAP)

Why choose us:
At Prairie Community Services, we respect life, self, colleagues and others. We support individuals who receive services in our residential programs and through Community- Based Services by assessing and utilizing their strengths and skills to encourage, teach, and help them to achieve their hopes and dreams.
As part of a mission-focused nonprofit that values integrity, commitment, respect, excellence, service and stewardship, we will train you for success!
Prairie Community Services is an Equal Opportunity Employer.
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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