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Program Integrity Director Jobs in New York (NOW HIRING)

Bond Health

Program Director

New York, NY

Program Director needed in Brooklyn Full time-Shelter setting Responsibilities: * Main professional ... Ensure staff utilization of electronic database and conduct oversight to ensure data integrity.

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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.
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Program Integrity Director jobs near you
Program Director 1

Program Director 1

Volunteers of America Delaware Valley

Somerville, NJ

Full-time

Posted 5 days ago

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Job description

The employee in this classification shall report to the Regional Director of Supportive Services or Vice President of Supportive Services. The Program Director provides leadership and ensures program integrity. The responsibilities are managerial in function. The Program Director is responsible for the administration and operations of the program(s) and is accountable for the general welfare of staff and clients. The Program Director oversees the supervision of all staff and clients and the safety and security of the program(s). The Program Director is responsible for ensuring contract compliance and all reporting procedures and appropriate fiscal management. Scope of Duties:

1. Interact with all clients, staff, and outside contacts with respect and courtesy.

2. Maintain client and staff confidentially in compliance with administrative policies and procedures.

3. Attend and participate in regularly scheduled staff meetings, supervisory conferences, and training sessions.

4. Supervise assigned staff including the completion of performance evaluations and regularly scheduled supervisory sessions.

5. Ensure compliance with the agency Administrative Policies and Procedures.

6. Develop, implement, and maintain Program Policy and Procedures Manual including ongoing review and update.

7. Prepare recommendations for the annual budget with input from direct reports anticipating personnel and operational needs for the upcoming fiscal year.

8. Ensure quality delivery of all program services.

9. Assess staff training needs and coordinate staff development plans.

10. Conduct regular Program Management Meetings, Team Meetings, StaffMeeting,s and House/Client Meetings.

11. Conduct regular program evaluations to ensure program integrity.

12. Ensure contract compliance and a positive relationship with funding source(s).

13. Conduct regular, unscheduled off-hour visits to the program(s).

14. Actively recruit for vacant staff positions to ensure appropriate levels of staff supervision in the program.

15. Follow all safety and security procedures required by agency and licensing agencies and/or funding source(s).

16. Network with other community agencies to develop resources for clients.

17. Represent agency and actively participate on appropriate external coalitions, committees, and meetings.

18. Ensure the collection of all data to support outcome studies required by the agency or funding source.

Complete any duties assigned. ADA Essential Functions