Department Program Integrity Operations Job Summary * Investigate providers of various Medicaid ... Notify management of any trends that are a direct cause of or contributing factor to errors that ...
Department Program Integrity Operations Job Summary * Investigate providers of various Medicaid ... Notify management of any trends that are a direct cause of or contributing factor to errors that ...
Department Program Integrity Operations Job Summary * Investigate providers of various Medicaid ... Notify management of any trends that are a direct cause of or contributing factor to errors that ...
Department Program Integrity Operations Job Summary * Investigate providers of various Medicaid ... Notify management of any trends that are a direct cause of or contributing factor to errors that ...
Program Director
Baton Rouge, LA ยท On-site
The Program Director is responsible for the strategic leadership, compliance oversight, and ... Ensure data integrity within grant management and case management systems. โข Oversee ...
Program Director
Baton Rouge, LA ยท On-site
The Program Director is responsible for the strategic leadership, compliance oversight, and ... Ensure data integrity within grant management and case management systems. โข Oversee ...
This position will manage direct reports and support the Site Manager or Project Manager in ... program. * Integrity in dealings with other associates and clients. * Ability to work with other ...
This position will manage direct reports and support the Site Manager or Project Manager in ... program. * Integrity in dealings with other associates and clients. * Ability to work with other ...
This position will manage direct reports and support the Site Manager or Project Manager in ... program. * Integrity in dealings with other associates and clients. * Ability to work with other ...
This position will manage direct reports and support the Site Manager or Project Manager in ... program. * Integrity in dealings with other associates and clients. * Ability to work with other ...
Economic Stability Supervisor
Baton Rouge, LA ยท On-site
$3.9K - $7.1K/mo
... direct impact on community well-being while supporting program integrity and compliance. Please note: Applicants must clearly describe their experience with specific Economic Stability, Medicaid ...
Economic Stability Supervisor
Baton Rouge, LA ยท On-site
$3.9K - $7.1K/mo
... direct impact on community well-being while supporting program integrity and compliance. Please note: Applicants must clearly describe their experience with specific Economic Stability, Medicaid ...
Economic Stability Supervisor
Baton Rouge, LA ยท On-site
$3.9K - $7.1K/mo
... direct impact on community well-being while supporting program integrity and compliance. Please note: Applicants must clearly describe their experience with specific Economic Stability, Medicaid ...
Economic Stability Supervisor
Baton Rouge, LA ยท On-site
$3.9K - $7.1K/mo
... direct impact on community well-being while supporting program integrity and compliance. Please note: Applicants must clearly describe their experience with specific Economic Stability, Medicaid ...
FQHC Revenue Systems Director
Clinton, LA ยท On-site
Familiarity with sliding fee discount programs, Medicare/Medicaid cost reporting, and encounter ... Oversee audits, documentation standards, and revenue integrity processes. * Establish workflows and ...
Quick apply
FQHC Revenue Systems Director
Clinton, LA ยท On-site
Familiarity with sliding fee discount programs, Medicare/Medicaid cost reporting, and encounter ... Oversee audits, documentation standards, and revenue integrity processes. * Establish workflows and ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
Director of Business Operations
Baton Rouge, LA ยท On-site
$28/hr
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
Director of Business Operations
Baton Rouge, LA ยท On-site
$28/hr
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... programs required. Experience in Yardi would be of significant benefit. * College Degree in ...
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
National Creative Services Art Director
Baton Rouge, LA ยท On-site
$1.2K/wk
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
National Creative Services Art Director
Baton Rouge, LA ยท On-site
$1.2K/wk
A 6-week comprehensive training program * Ongoing professional development and internal leadership ... Meticulous attention to detail with a strong commitment to accuracy, quality, and brand integrity.
Program Manager 1 - Social Services
Baton Rouge, LA ยท On-site
$5.2K - $9.4K/mo
We are proud to serve the people of Louisiana with integrity, innovation, and a deep commitment to ... Responsible for direct supervision of five Program Consultants in the Procurement Section.
Program Manager 1 - Social Services
Baton Rouge, LA ยท On-site
$5.2K - $9.4K/mo
We are proud to serve the people of Louisiana with integrity, innovation, and a deep commitment to ... Responsible for direct supervision of five Program Consultants in the Procurement Section.
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
Program Manager 1 - Social Services
Baton Rouge, LA ยท On-site
$5.2K - $9.4K/mo
We are proud to serve the people of Louisiana with integrity, innovation, and a deep commitment to ... Responsible for direct supervision of five Program Consultants in the Procurement Section.
Program Manager 1 - Social Services
Baton Rouge, LA ยท On-site
$5.2K - $9.4K/mo
We are proud to serve the people of Louisiana with integrity, innovation, and a deep commitment to ... Responsible for direct supervision of five Program Consultants in the Procurement Section.
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
... Integrity, Safety, & Joy. We are looking for team members who want to serve others. We offer a ... Successfully follows a preventative maintenance program set forth by the Director of Facility ...
Business Ethics: Demonstrate integrity, respect, and discretion in all business dealings ... Employee Assistance Program (EAP) * Career development and ongoing training Important to Know
Business Ethics: Demonstrate integrity, respect, and discretion in all business dealings ... Employee Assistance Program (EAP) * Career development and ongoing training Important to Know
Program Integrity Director information
See Baton Rouge, LA salary details
$28.3K - $37.7K
5% of jobs
$37.7K - $47.1K
13% of jobs
$50.6K is the 25th percentile. Wages below this are outliers.
$47.1K - $56.5K
19% of jobs
The median wage is $64.9K / yr.
$56.5K - $65.9K
15% of jobs
$65.9K - $75.2K
11% of jobs
$84.1K is the 75th percentile. Wages above this are outliers.
$75.2K - $84.6K
14% of jobs
$84.6K - $94K
9% of jobs
$94K - $103.4K
5% of jobs
$103.4K - $112.8K
2% of jobs
$112.8K - $122.2K
2% of jobs
$122.2K - $131.6K
5% of jobs
$28.3K
$75.1K
$131.6K
How much do program integrity director jobs pay per year?
What are the key skills and qualifications needed to thrive as a Program Integrity Director, and why are they important?
What is the difference between Program Integrity Director vs Claims Manager?
| Aspect | Program Integrity Director | Claims Manager |
|---|---|---|
| Required Credentials | Bachelor's degree, certifications in healthcare compliance or auditing | Bachelor's degree, experience in claims processing or insurance |
| Work Environment | Healthcare or insurance organizations, compliance departments | Insurance companies, healthcare payers, claims processing units |
| Employer & Industry Usage | Used in healthcare, government programs, insurance sectors | Primarily 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?
What are some typical challenges faced by a Program Integrity Director, and how can they be addressed?
Full-time
Posted 18 days ago
Job description
Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.
You must complete all required portions of the application and attach the required documents in order to be considered for employment.
Department
Program Integrity Operations
Job Summary
Job Description
- Investigate providers of various Medicaid programs to ensure expenditures are made in accordance with Federal and State regulations.
- Process and track all Medicaid provider and recipient related complaints reported via email, the Medicaid Fraud website or internally.
- Interacts with varies internal and external entities such as Medicaid recipients, Medicaid providers, LDH program operations, licensing boards, the Attorney General's office, etc.
- Document findings of investigations initiated by referrals from Medicaid programs including but not limited to OAAS, Behavioral Health, Provider Enrollment, MFCU and Plans.
- Detail any corrective action(s) necessary after conducting a comprehensive case review of findings.
- Ensure all providers are furnished with a written notification of any corrective actions and cite the applicable Medicaid/LaCHIP policy reference.
- Assist in maintaining records of provider fraud, waste and abuse referrals for investigation.
- Maintain findings and results on fraud referrals received within the centralized tracking system.
- Conducts research on all policy violations and corrective action.
- Maintains and assists with up-to-date reporting statistics and data for unit reports.
- Notify management of any trends that are a direct cause of or contributing factor to errors that come to light during the review process or while tracking all cases received for review.
- Refer applicable cases to the Office of the Attorney General.
- Prepare written summary report with all relevant background facts.
- Provide any assistance needed to the legal authority.
- May be called upon as a witness to a case once it proceeds to trial.
- Complete special projects as directed by management.
QUALIFICATIONS
REQUIRED:
- Bachelor's Degree, or Associates degree with 3 years professional experience, or 6 years professional experience in lieu of the degree.
- Excellent analytical skills, effective organizational and time management skills.
- Excellent verbal and written communications skills.
- Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel.
DESIRED:
- Advanced degree.
- 2 years professional experience in provider enrollment and credentialing.
- 1 year professional experience with Louisiana Medicaid policy and procedures.
- Experience with Electronic Visit Verification.
- Experience with data analysis and report development.
SALARY: 37-47k
Required Attachments
Please upload the following documents in the Resume/Cover Letter section.
- Detailed resume listing relevant qualifications and experience;
- Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems;
- Names and contact information of three references;
Applications that do not include the required uploaded documents may not be considered.
Posting Close Date
This position will remain open until filled.
Note to Applicant:
Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.
References will be contacted at the appropriate phase of the recruitment process.
This position may require a criminal background check to be conducted on the candidate(s) selected for hire.
As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.
The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.
About University of New Orleans
Sourced by ZipRecruiter
Industry
Colleges, universities, and professional schools
Company size
1,001 - 5,000 Employees
Headquarters location
New Orleans, LA, US
Year founded
1958