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Program Integrity Director Jobs in Minnesota (NOW HIRING)

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Government General Counsel (Virginia)

Virginia, MN · On-site

... program integrity, discovering, and recovering revenue, and making timely and informed decisions to ... LNSSI Board of Directors * Serve as legal counsel and secretary to the LNSSI Board of Directors

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Program Integrity Director information

What is a program integrity director?

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 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 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

OIG Vendor Select 4 resource types (MG/EM)

HonorVet Technologies

Saint Paul, MN • On-site

Other

Posted 19 days ago

Job description

Description of Project
The Minnesota Client also referred to as "Client " or "State " is seeking a vendor to provide program and project management resources to assist and lead initiatives for the Office of Inspector General's (OIG) Digital Services, Analytics, and Insights (DSAI) team as they continue to expand and maintain the Provider and Agency Solutions Product Line and support other Client and Department of Children, Youth, and Families (DCYF) initiatives.
At a high level, the vendor's resources will support the addition of new license types, development of cross-cutting legal appeals functionality, integration with state systems, enhancement of case management capabilities, and improvements to data pipelines. This work supports the Agency's broader initiative to transform licensing digital platform. The platform is built on Salesforce Public Sector Solutions and is central to the Agency's transformation of licensing and case management.
As part of these efforts, Client will be engaging vendors to provide project management services for the scope outlined in this solicitation as well as completing software development configuration and implementation. The vendor selected from this solicitation will be responsible for providing program and project management over those efforts and will also be responsible for oversight of other vendors involved in the project as well as engagement with other Client and MNIT teams including OIG DSAI, Legal, PIO (Program Integrity and Oversight), MNIT @Client, MNIT Enterprise, and potentially DCYF product teams and MNIT @DCYF teams.
Scope Overview:
  • Expansion of current child care functionality to new license types including Home and Community Based Services (HCBS), Foster Care, Early Intensive Development and Behavioral Intervention (EIDBI), USS (Uniform Service Standard) and others.
  • Development of legal appeals case management features.
  • Integration with NetStudy 2.0, Minnesota Provider Screening and Enrollment System (MPSE), and Medicaid Management Information System (MMIS).
  • Enhancement of Product Success case management features.
  • Development of improved data pipelines into OIG's Azure Databricks Data Lakehouse.
  • Other efforts established as priorities for OIG.

Senior Project Manager
Tasks / Responsibilities
A Senior Project Manager (Sr. PM) is responsible for delivering high-complexity, high-visibility projects on time, within budget, and to agreed quality standards-while managing risk, stakeholders, and strategic alignment.
Expected tasks and responsibilities:
  • Define project scope, objectives, and deliverables in collaboration with sponsors and stakeholders.
  • Develop detailed project plans, schedules, and budgets.
  • Establish governance structure, escalation paths, and decision-making processes.
  • Lead the day-to-day management of project teams, ensuring alignment to the plan.
  • Track progress against schedule and budget; take corrective action as needed.
  • Manage scope changes vi formal change control process.
  • Build and maintain strong relationships with sponsors, customers, and other stakeholders.
  • Facilitate steering committee meetings, status updates, and decision-making sessions.
  • Monitor project budgets, forecasts, and actual costs.
  • Report variances and recommend adjustments.
  • Identify, assess, and manage project risks and issues, including development of mitigation and contingency plans.
  • Escalate critical risks/issues to leadership when necessary.
  • Lead cross-functional teams, including vendors and contractors.
  • Provide coaching, mentoring, and guidance to project managers or coordinators.
  • Foster collaboration and problem-solving within the team.
  • Ensure adherence to organizational PMO standards, methodologies, and templates.
  • Maintain proper documentation for audits, compliance, or lessons learned.
  • Ensure regulatory and contractual requirements are met.
  • Produce clear, accurate project status reports, dashboards, and presentations.
  • Translate technical or complex updates into business-friendly language for executives.
  • Keep stakeholders informed of progress, risks, and decisions needed.
Experience / Qualifications
  • 7-10+ years of progressively responsible project management experience, including leading enterprise-wide or highly complex projects.
  • Proven track record managing large teams across departments, geographies, and possibly vendors or contractors.
  • Deep knowledge of both predictive (Waterfall) and adaptive (Agile/Hybrid) methodologies, with the ability to choose the right approach for the project.
  • Demonstrated experience managing large budgets, and cost forecasting.
  • Proven ability to proactively identify, assess, and resolve high-impact risks/issues.
  • Experience working with government agencies.
  • Experience leading organizational change initiatives, including stakeholder adoption and process transition.
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About HonorVet Technologies

Sourced by ZipRecruiter

HonorVet Technologies, located in Fairfield, NJ, US, is a technology-driven company with a unique dimension - enhancing veteran engagement in the workforce. Founded with the goal of supporting and preserving professional veterans while satisfying the IT and professional needs of businesses, HonorVet Technologies brings a particular focus to diversity and veteran hiring, making it a standout player in the IT and Staffing industries. Functioning as a veteran-driven community entity, the firm offers IT staffing, bespoke development, and consulting services, with the aim of connecting talents with IT-related job opportunities.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Fairfield , NJ, US

Year founded

2015

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