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 · On-site
The Program Director is responsible for the strategic leadership, compliance oversight, and ... Ensure data integrity within grant management and case management systems. • Oversee ...
Program Director
Baton Rouge, LA · On-site
The Program Director is responsible for the strategic leadership, compliance oversight, and ... Ensure data integrity within grant management and case management systems. • Oversee ...
... directed. * Provide field office support for Mechanical Integrity activities during plant ... Maintain, update, and format Mechanical Integrity procedures as required when program changes are ...
... directed. * Provide field office support for Mechanical Integrity activities during plant ... Maintain, update, and format Mechanical Integrity procedures as required when program changes are ...
... directed. * Provide field office support for Mechanical Integrity activities during plant ... Maintain, update, and format Mechanical Integrity procedures as required when program changes are ...
... directed. * Provide field office support for Mechanical Integrity activities during plant ... Maintain, update, and format Mechanical Integrity procedures as required when program changes are ...
ADMINISTRATIVE PROGRAM DIRECTOR 3 (Procurement)
Baton Rouge, LA · On-site
$5.38K - $10.55K/mo
... integrity of Louisiana's elections, and preserves, presents, and makes accessible government ... The Louisiana Secretary of State is seeking to fill a vacant Administrative Program Director 3 ...
ADMINISTRATIVE PROGRAM DIRECTOR 3 (Procurement)
Baton Rouge, LA · On-site
$5.38K - $10.55K/mo
... integrity of Louisiana's elections, and preserves, presents, and makes accessible government ... The Louisiana Secretary of State is seeking to fill a vacant Administrative Program Director 3 ...
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 ...
MEDICAID ANALYST SUPERVISOR
Baton Rouge, LA · On-site
$3.98K - $7.17K/mo
... to strengthening program integrity and improving outcomes for Louisiana families. An ideal ... Monitors case development through reviews as directed by agency policy, previous review findings ...
MEDICAID ANALYST SUPERVISOR
Baton Rouge, LA · On-site
$3.98K - $7.17K/mo
... to strengthening program integrity and improving outcomes for Louisiana families. An ideal ... Monitors case development through reviews as directed by agency policy, previous review findings ...
Program Coordinator- Uniform For Kids
Baton Rouge, LA · On-site
$10 - $16/hr
Engage with a passionate team that embodies our values of humility, empathy, and integrity while ... Collaborating closely with the Director of Retail Operations, store managers, community partners ...
Quick apply
Program Coordinator- Uniform For Kids
Baton Rouge, LA · On-site
$10 - $16/hr
Engage with a passionate team that embodies our values of humility, empathy, and integrity while ... Collaborating closely with the Director of Retail Operations, store managers, community partners ...
Administrative Program Specialist B
Baton Rouge, LA · On-site
$3.35K - $6.57K/mo
Acting with Ethics and Integrity: The ability to make choices that reflect ethical standards ... CFS Director. Miscellaneous- Assures compliance of hospital and departmental regulations and ...
Administrative Program Specialist B
Baton Rouge, LA · On-site
$3.35K - $6.57K/mo
Acting with Ethics and Integrity: The ability to make choices that reflect ethical standards ... CFS Director. Miscellaneous- Assures compliance of hospital and departmental regulations and ...
Sales Director
Baton Rouge, LA · Remote
... marketing program recommendations based on client needs • Negotiate pricing/contracts with ... Integrity, Truth, and Reality 03: Kindness, Empathy, and Grace 04: Resilience, Mettle, and ...
Sales Director
Baton Rouge, LA · Remote
... marketing program recommendations based on client needs • Negotiate pricing/contracts with ... Integrity, Truth, and Reality 03: Kindness, Empathy, and Grace 04: Resilience, Mettle, 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 · 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 · 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 ...
Program Generalist
Baton Rouge, LA · On-site
$20.92/hr
This position reports directly to the Behavioral Health Clinical Director and serves as support to ... Maintains the integrity of personnel files and ensures all required updates to files are completed ...
Quick apply
Program Generalist
Baton Rouge, LA · On-site
$20.92/hr
This position reports directly to the Behavioral Health Clinical Director and serves as support to ... Maintains the integrity of personnel files and ensures all required updates to files are completed ...
Director of Instructional Technology
Baton Rouge, LA · Hybrid
$89.15K - $104.65K/yr
Ensure data accuracy, integrity, and accessibility across platforms. Partner with school leadership ... training programs. Collaborate with academic leadership to manage instructional platforms ...
Director of Instructional Technology
Baton Rouge, LA · Hybrid
$89.15K - $104.65K/yr
Ensure data accuracy, integrity, and accessibility across platforms. Partner with school leadership ... training programs. Collaborate with academic leadership to manage instructional platforms ...
Network Director - Louisiana Resident
Baton Rouge, LA · On-site +1
$105.23K - $178.89K/yr
... etc), database integrity and maintenance, regular reports, and rate loading. * Develops and ... Establishes programs to develop and maintain positive relationships between MBH and providers, and ...
Network Director - Louisiana Resident
Baton Rouge, LA · On-site +1
$105.23K - $178.89K/yr
... etc), database integrity and maintenance, regular reports, and rate loading. * Develops and ... Establishes programs to develop and maintain positive relationships between MBH and providers, and ...
Integrity, Compassion, Accountability, Respect, and Excellence Central Louisiana State Hospital ... Participate in continuing education programs. Annually review and update Medical Staff Bylaws and ...
Integrity, Compassion, Accountability, Respect, and Excellence Central Louisiana State Hospital ... Participate in continuing education programs. Annually review and update Medical Staff Bylaws and ...
The Physician/Medical Director - Region or Facility plays a vital role for the Louisiana Department ... Participate in continuing education programs. * Annually review and update Medical Staff Bylaws and ...
The Physician/Medical Director - Region or Facility plays a vital role for the Louisiana Department ... Participate in continuing education programs. * Annually review and update Medical Staff Bylaws and ...
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 are some typical challenges faced by a Program Integrity Director, and how can they be addressed?
What are Program Integrity Directors?
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.
Full-time
Posted 23 days ago
Job description
Thank you for your interest in The University of New Orleans.
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 OperationsInvestigate 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.
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