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Program Integrity Director Jobs in Miami Beach, FL

Flipany

Program Monitor

Miami, FL · On-site

... Director. As a sponsoring organization, FLIPANY provides oversight to providersparticipatingin thefederal food programin the areas of program accountability and nutrition integrity.He or she works ...

Robert Half

Risk Manager

Fort Lauderdale, FL · On-site

$43.70 - $50.60/hr

Build and maintain effective working relationships with Medicaid program integrity representatives, including participation in collaborative meetings and timely responses to inquiries. * Direct ...

Flipany

Program Monitor

Miami, FL · On-site

$17.50 - $18.50/hr

... Director. As a sponsoring organization, FLIPANY provides oversight to providers participating in the federal food program in the areas of program accountability and nutrition integrity. He or she ...

Aston Carter

SIU Manager

Sunrise, FL · On-site

$43.27 - $48.07/hr

Accountable for establishing and maintaining a relationship with AHCA-Medicaid Program Integrity as ... Other duties as directed based on business needs, department priorities. Nationwide acceptable ...

Aston Carter

SIU Manager

Fort Lauderdale, FL

$43.27 - $48.07/hr

Other duties as directed based on business needs, department priorities. Nationwide acceptable ... Minimum of 5-7 years of experience in a healthcare program integrity role ensuring compliance with ...

Quadel Consulting & Training

Manager

Miami, FL · On-site

Advises the Managing Director of the status and needs of the program(s) * Writes and prepares weekly, monthly and annual reports. * Demonstrates superior seamless customer service, integrity, and ...

Quadel Consulting and Training LLC

Manager

Miami, FL · On-site

Advises the Managing Director of the status and needs of the program(s) * Writes and prepares weekly, monthly and annual reports. * Demonstrates superior seamless customer service, integrity, and ...

Alivi Health

Compliance Manager

Miami, FL · On-site

Identify emerging risks in operations, claims processing, vendor management, and program integrity ... Oversees and provides direct supervision to the Compliance, Fraud, Waste and Abuse (FWA), and ...

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All JobsProgram Integrity JobsProgram Integrity Director JobsProgram Integrity Director Jobs in Miami Beach, FL

Program Integrity Director information

See Miami Beach, FL salary details

$29.1K

$77.2K

$135.3K

How much do program integrity director jobs pay per year?

As of Aug 12, 2026, the average yearly pay for program integrity director in Miami Beach, FL is $77,219.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,300.00 and $91,300.00 per year, depending on experience, location, and employer.

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 is a program integrity director?

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 job categories do people searching Program Integrity Director jobs in Miami Beach, FL look for? The top searched job categories for Program Integrity Director jobs in Miami Beach, FL are:
What cities near Miami Beach, FL are hiring for Program Integrity Director jobs? Cities near Miami Beach, FL with the most Program Integrity Director job openings:
Program Integrity Director jobs near you
Infographic showing various Program Integrity Director job openings in Miami Beach, FL as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, 1% Temporary, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $77,219 per year, or $37.1 per hour.

Director of 340B Pharmacy Program

The University of Miami

Miami, FL • On-site

Full-time

Medical, Dental

Re-posted 3 days ago

University Of Miami rating

7.7

Company rating: 7.7 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

260th of 618 rated colleges and universities

Job description

Current Employees:
If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet.
CORE JOB FUNCTIONS
  • Provide enterprise-wide oversight of the 340B program to ensure compliance with state and federal laws, HRSA requirements, accreditation standards, licensure requirements, and pharmacy regulatory standards across all applicable settings.
  • Monitor and interpret evolving 340B and pharmacy regulatory requirements; develop policies, procedures, educational materials, and staff training programs to promote compliance, accountability, and best practices.
  • Lead and coordinate 340B audits, gap analyses, tracers, risk assessments, and corrective action plans to ensure program integrity, accurate documentation, and operational readiness.
  • Collaborate with pharmacy leadership, medical staff, patient care teams, HR, and other hospital departments to support medication management compliance, employee PBM/benefit coordination, and 340B optimization opportunities across the continuum of care.
  • Maintain oversight of 340B program operations, analytics, records management, HRSA updates, ambulatory pharmacy supply chain support, and pharmacy informatics/data analysis to drive program performance and identify improvement opportunities.
  • Support pharmacy financial and operational functions, including business planning, contract analysis, charge capture, financial controls, and departmental record systems, as assigned by the Chief Pharmacy Officer.
  • Ensure pharmacy services and program initiatives are responsive to the needs of diverse patient populations, supporting safe, effective, and patient-centered care.
  • Serve as the primary liaison for the 340B program, building strong relationships with internal and external stakeholders, representing the organization on committees and industry forums, and communicating program goals, risks, progress, and outcomes to senior leadership.
  • Provide strategic leadership and oversight of the 340B team, including managers and coordinators, by setting direction, driving program execution, fostering a culture of accountability and collaboration, and supporting staff development and performance.
  • Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with University policies and procedures. Ensures employees are trained on controls within the function and on University policy and procedures.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS
Education:
Bachelor's in pharmacy or Pharm.D. degree, Master's or MBA Preferred.
Certification and Licensing:
Active Florida Pharmacist license obtained within 6 months of hire. 340b and Apexus certification
Experience:
Minimum 7 years of relevant experience
Knowledge, Skills and Attitudes:
  • Ability to work effectively with a multidisciplinary team and handle multiple responsibilities.
  • Ability to execute and operationalize initiatives.
  • Knowledge of healthcare safety, clinical, regulatory and operational management principles.
  • Ability to execute and operationalize enterprise strategies set by executive leadership.
  • Ability to direct, manage, and evaluate multi-site, multi-service pharmacy operations.
  • Strong analytics, financial and operational management skills, with ability to balance budgets and optimize contracts.
  • Ability to lead, motivate, and develop high-performing operational teams.
  • Ability to leverage analytics, AI, and cohort insights to achieve measurable improvements in patient care and financial outcomes.

DEPARTMENT ADDENDUM
Department Specific Functions
Unit-Specific Responsibilities
Essential Duties:
  • Split-Billing Software Maintenance:
    • Resolves unmatched crosswalk items.
    • Reviews the activity of component CDMs and adjusts the accumulator as necessary
    • Reviews autosub activity and adjusts the crosswalk and accumulators as necessary
    • Split-Billing Software Maintenance:
    • Resolves unmatched crosswalk items.
    • Reviews the activity of component CDMs and adjusts the accumulator as necessary
    • Reviews autosub activity and adjusts the crosswalk and accumulators as necessary
    • Reviews of negative accumulators
    • Reviews of unusually large accumulators
    • Reviews of large purchases
    • Enters non-EDI activity
  • Rules/Guidance Surveillance:
    • Monitors and assesses 340B guidance and/or rule changes.
    • Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations.
    • Develops knowledge and maintains awareness of current regulations, trends, and issues pertaining to the 340B program.
    • Collaborates with the Prime Vendor Program, pharmacy leadership, and other 340B institutions.
    • Self-Audits:
    • Develops, executes, and documents self-audits of the 340B process. Coordinates and ensures remediation of findings.
    • Reviews and monitors all points of service where 340B participation occurs to ensure policy and procedure compliance, covered entity eligibility, and "covered patient" eligibility.

  • Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues.
  • Evaluates patient eligibility for qualified and non-qualified patients in hospital-based mixed-use areas by reviewing patient medical records, insurance plans, and hospital status.
  • 340B Program Coordination:
    • Serves as the primary internal program coordinator and liaison for all 340B-related matters.
    • Serves as the institutional "compliance expert" on 340B regarding program details, policies, and procedures of the virtual inventory processes required for mixed-use areas.
    • Serves as primary internal liaison to key stakeholders to help ensure appropriate utilization of the 340B program and compliance with all program requirements.
    • Acts as the liaison with necessary departments to ensure 340B program integrity.
    • Collaborate with UHEALTH 340B Program Manager.
    • Collaborates with UHEALTH Legal and Finance.
  • External Audits:
    • Serves as the point person and coordinator for all audits.
    • Coordinates all requests and responses.
    • Maintains a current state of "audit readiness".
    • Provides oversight for all audits performed by independent external auditors.
  • Reporting:
    • Assists in monitoring reports to ensure compliance with the program.
    • Reviews 340B cast savings reports

Routinely communicates any issues or concerns with pharmacy leadership.
The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.
The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.
Job Status:
Full time
Employee Type:
Staff

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About University of Miami

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The University of Miami, located in the beautiful Coral Gables, Florida, is a comprehensive, private research institution in the United States. Operating within the higher education industry, the institution offers a multitude of degree programs spanning over 180 majors and program through its 12 colleges. The University was founded in 1925 with the mission to disseminate knowledge, transform lives, and change the world - a mission it has held faithfully to this day. Notably, the University of Miami has gained global recognition for its commitment to research and innovation, with over $324 million in research and sponsored project funding awarded annually.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Coral Gables, FL, US

Year founded

1925

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