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Program Integrity Director Jobs in Wyoming (NOW HIRING)

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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
Director of Human Resources - RiverPeak Health, Riverton, WY

Director of Human Resources - RiverPeak Health, Riverton, WY

Billings Clinic

Riverton, WY

Other

Medical, Retirement

Re-posted 8 days ago

Job description

THIS IS A COURTESY POSTING ONLY
Please do not complete the employment application on this site/Apply below

Application Link:  RiverPeak Employment

 
Director of Human Resources

Riverton, WY

We're looking for a Director of Human Resources to help create our team!

The Director of Human Resources serves as a key member ofthe executive leadership team and is responsible for the strategic development,implementation, and oversight of all human resources functions at RiverPeakHealth.  This role is foundational to the organization and will leadthe design, build, and execution of HR systems, workforce strategies, andorganizational culture in a start-up healthcare environment.  The HR Director will ensure RiverPeak Health attracts,develops, and retains a high-performing workforce while maintaining compliancewith all applicable employment laws, regulatory requirements, andorganizational standards.

ESSENTIAL FUNCTIONS

1. Executive Leadership & Strategy

Serve as a strategic partner to the CEO and executive leadership team
Develop and implement HR strategies aligned with organizational goals
Participate in organizational planning, workforce strategy, and growth initiatives
Provide guidance to leadership on workforce planning, organizational design, and culture

2. Organizational Build & Start-Up Execution

Lead development of:
HR policies, procedures, and employee handbook
Compensation structures and benefits programs
Job descriptions and position classifications
Onboarding and orientation programs
Establish HR systems, including HRIS, personnel records, and reporting tools
Support full-cycle recruitment and hiring for all departments
Partner with leadership on staffing models and workforce planning

3. Talent Acquisition & Workforce Planning

Develop and execute a comprehensive recruitment strategy
Partner with department leaders to identify staffing needs and hiring timelines
Oversee job postings, candidate screening, interviewing, and offer processes
Implement strategies to attract and retain talent in a rural healthcare market

4. Employee Relations & Culture

Foster a positive, engaged, and mission-driven workplace culture
Provide coaching and guidance to leaders on employee relations matters
Manage and resolve complex employee relations issues
Promote employee engagement, retention, and professional development
Encourage open communication and collaboration across the organization

5. Compensation, Benefits & Performance Management

Design and manage compensation structures, salary bands, and incentive programs
Oversee benefits programs including health, retirement, and leave policies
Lead performance management processes, including evaluations and feedback systems
Ensure internal equity and market competitiveness

6. Compliance & Risk Management

Ensure compliance with all federal, state, and local employment laws and regulations (e.g., FLSA, EEOC, OSHA, ADA)
Develop and maintain HR policies to ensure regulatory and accreditation compliance
Oversee employee records, credentialing support, and documentation practices
Manage HR-related audits, investigations, and risk mitigation efforts

7. Training & Development

Develop and implement training programs for:
Leadership development
New employee orientation
Compliance and mandatory education
Support ongoing professional development and workforce capability building

8. HR Operations & Systems

Establish and oversee HRIS and data systems
Develop HR metrics and dashboards to track:
Recruitment
Retention
Engagement
Workforce productivity
Ensure accuracy, confidentiality, and integrity of HR data
Leadership Philosophy & Expectations
Serve as a visible, accessible leader who is actively engaged with staff across the organization
Foster a culture of servant leadership, accountability, and collaboration
Act as a trusted advisor to leadership and a resource for employees
Demonstrate a hands-on approach in building HR systems, supporting hiring efforts, and resolving workforce challenges
Lead by example in professionalism, integrity, and alignment with organizational values

MINIMUIM QUALIFICATIONS

Required

 Bachelor's degree in Human Resources, Business Administration, or related field
 Minimum 5-7 years of progressive human resources leadership experience
 Demonstrated experience in HR operations, employee relations, and talent management

Preferred

 Master's degree (HR, MBA, MHA, or related field)
 HR certification (SHRM-CP, SHRM-SCP, PHR, or SPHR)
Experience in:
 Healthcare or hospital setting
 Start-up, growth, or organizational build environments
 Rural workforce recruitment and retention strategies

Job Type:  Full-Time

Apply Here:  RiverPeak Employment

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