Director of Program Integrity - Lead Fraud, Waste & Abuse Prevention for a Major Health Plan Job at KA Recruiting Inc., Plano, TX

VnBuQm5sUEtiWlZuRFhvcERMMzEwaVZE
  • KA Recruiting Inc.
  • Plano, TX

Job Description

Job Description

Join a leading Texas-based health plan dedicated to advancing quality, compliance, and cost efficiency across Medicaid and managed care programs. As the Director of Program Integrity , you’ll lead strategic initiatives that ensure payment accuracy and safeguard against fraud, waste, and abuse — driving real impact across the organization.

Shift Details
Full-time, Days – Monday through Friday, 8:00 AM to 5:00 PM

Compensation and Benefits
Competitive compensation commensurate with experience.
Comprehensive benefits include medical, dental, vision, life insurance, disability coverage, flexible spending accounts, and more.

Why Join Us

  • Leadership-level opportunity influencing statewide Medicaid and managed care performance

  • Highly visible role within a respected and growing health plan

  • Collaborative, mission-driven culture focused on community and integrity

  • Excellent work-life balance with weekday hours

  • Strong benefits and professional development support

Your Role

  • Direct operations and strategy for the Program Integrity department

  • Oversee functions related to claims editing, audit strategy, and FWA prevention

  • Drive continuous process improvement to ensure compliance and cost containment

  • Partner with leadership to monitor program outcomes and performance metrics

  • Supervise and mentor staff while fostering a high-performing, compliant team culture

  • Manage department budgets, policies, and annual goals

About the Location
Located in Plano, Texas , this thriving Dallas suburb offers a perfect balance of professional opportunity and quality of life. Plano is known for its excellent schools, vibrant corporate community, and wide range of dining and cultural options—just a short drive from downtown Dallas.

Job Tags

Full time, Monday to Friday, Flexible hours, Shift work, Weekday work,

Similar Jobs

National Neuropathy Centers

Physician Assistants PA / Nurse Practitioners NA Job at National Neuropathy Centers

 ...unique medical clinic group. We are one of the few nationwide centers dedicated exclusively to all types of Peripheral Neuropathy. Our FDA-approved services have brought hope to hundreds of thousands of patients. We are committed to excellence in patient care, offering... 

Speedy Glass

Auto Glass Technician Job at Speedy Glass

 ...We are looking to add an experienced Auto Glass Technician to our growing team in Auburn, WA! Auto Glass Technicians begin with a starting salary of $24.00-$28.00 + bonus opportunities Responsibilities of an Auto Glass Technician include but are not limited to:... 

Lifestyle Discovery

Online Business Mentor (Remote & Flexible) (San Francisco) Job at Lifestyle Discovery

 ...enhance leadership impact, and foster business growth. Role Description This is a contract remote role for an Online Business Mentor. The Online Business Mentor will guide and support clients in business planning, provide mentorship, assist small business... 

Oceaneering International

Administrative Assistant Job at Oceaneering International

Get AI-powered advice on this job and more exclusive features.Company ProfileOceaneering is a global provider of engineered services and products, primarily to the offshore energy industry. We develop products and services for use throughout the lifecycle of an offshore... 

Management Unlimited, a division of A.B.S. Accounting & Tax ...

Part-Time Tax & Accounting Office Administrative Assistant Job at Management Unlimited, a division of A.B.S. Accounting & Tax ...

 ...Job Description Income Tax and Accounting Firm Role Description Set your own hours! This is a part-time, on-site role for a Tax & Accounting Office Administrative Assistant located in Menomonee Falls, WI. The Administrative Assistant will be responsible for...