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Program Integrity Director Jobs in Oregon (NOW HIRING)

Lead Revenue Cycle Strategy & Governance - Direct the development, implementation, and continuous ... E-Verify statement Employer participates in the Electronic Employment Verification Program. Please ...

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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 Oregon? For Program Integrity Director jobs in Oregon, the most frequently searched job titles are:
What cities in Oregon are hiring for Program Integrity Director jobs? Cities in Oregon with the most Program Integrity Director job openings:
Revenue Integrity, Revenue Cycle Director

Revenue Integrity, Revenue Cycle Director

Ascension

Remote

$138K - $195K/yr

Full-time

Medical, PTO

Posted 10 days ago


Ascension Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 1,008 frontline employees who took The Breakroom Quiz

404th of 873 rated healthcare providers


Job description

We Are Hiring

Department: Revenue Cycle

Schedule: Full-Time, Monday-Friday

Location: Remote with up to 25-50% travel

Salary: $138,258.29 - $195,187.61 per year

Eligible for an annual bonus incentive

#LI-Remote

#InternalOPS

What You Will Do
  • Lead Revenue Cycle Strategy & Governance - Direct the development, implementation, and continuous improvement of revenue cycle policies, practices, procedures, and operational standards to drive performance and compliance.
  • Oversee Analytics, Forecasting & Data Integrity - Deploy and optimize analytic tools and processes; forecast key business metrics; develop actionable reporting and recommendations; and ensure data quality and integrity.
  • Drive Financial Stewardship & Revenue Optimization - Oversee departmental budgets, support accounts receivable and revenue valuation reviews, and develop revenue valuation recommendations to inform leadership decisions.
  • Manage Strategic Partnerships & Operational Execution - Direct third-party relationships, including consultant engagement and billing operations while ensuring effective execution and accountability.
  • Advance Continuous Improvement & Best Practice Adoption - Identify improvement opportunities, drive process harmonization, develop remediation plans for identified gaps, and promote internal and external best practice sharing across the organization.
What You Will Need

Licensure / Certification / Registration:

  • Preferred Credential(s):
    • Accountant. Licensure required relevant to state in which work is performed

Education:

  • High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate's degree/Bachelor's degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management.
Additional Preferences
  • Familiarity with Cerner and/or Epic systems preferred
  • Prior leadership or people management experience
  • Background in acute care hospital operations

#InternalOps#LI-Remote

Why Join Our Team

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.

Equal Employment Opportunity Employer

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

Fraud prevention notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.

E-Verify statement

Employer participates in the Electronic Employment Verification Program. Please click here for more information.

Benefits

Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

Employment Type: FULL_TIME

What Ascension Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Ascension logo

About Ascension

Sourced by ZipRecruiter

Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Industry

Health care and social assistance and outpatient health care

Company size

10,000+ Employees

Headquarters location

St. Louis, MO, US