Perm Leadership Director of Program Integrity (Days) Dallas TX
Perm Leadership Director of Program Integrity (Days) Dallas TX
Posted on :
30-09-2025
Employer Active
1 Vacancy
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Job Description
Care Compassion Community.
As one of the largest public hospital systems in the country Parkland Health & Hospital System is dedicated to providing valuable health and well-being services to those entrusted to our care.
Hourly Range: Min BR Mid BR Max BR
As one of the largest public hospital systems in the country Parkland Health & Hospital System is dedicated to providing valuable health and well-being services to those entrusted to our care.
Hourly Range: Min BR Mid BR Max BR
25% Perm Placement Fee
The Director of Program Integrity provides leadership oversight and directs the operations for the Program Integrity department and
associated functions with focus on claims editing fraud waste and abuse (FWA) prevention and
payment accuracy. Accountable for supporting Parkland Community Health Plan s (PCHP) commitment
to operational excellence cost containment and adherence to state and federal requirements.
Job Responsibilities:
Job Responsibilities:
1. Identifies and analyzes the design of jobs work processes work flows etc. for the area and
implements appropriate changes to improve effectiveness productivity and efficiency that
support the overall goals of PCHP.
2. Stays abreast of the latest developments advancements and trends in the field by attending
seminars/workshops reading professional journals actively participating in professional
organizations and/or maintaining certification or licensure. Integrates knowledge gained into
current work practices.
3. Maintains knowledge of applicable rules regulations policies laws and guidelines that impact the
area. Develops effective internal controls designed to promote adherence with applicable laws
accreditation agency requirements and customer requirements. Seeks advice and guidance as
needed to ensure proper understanding.
4. Develops and monitors annual budgets that ensure the department has the necessary funds to
carry out the goals and objectives that have been established for the department.
5. Develops implements monitors and revises annual goals and objectives for the department that
support the missions and objectives of PCHP.
6. Selects trains schedules motivates supervises and evaluates employees making
recommendations for disciplinary actions up to and including termination to ensure maximum
utilization of individual and group capabilities. Ensures that assigned employees receive
opportunities to further their knowledge.
Skills or Special Abilities:
- Excellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines and with a variety of constituents as well as the ability to articulate complex information in understandable terms.
- Demonstrated ability to coach and influence for results.
- Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships with diverse groups across and beyond the organization.
- Strategic thinking and long-range planning skills with the ability to lead major organizational initiatives accomplish results and achieve measurable outcomes or goals.
- Ability to work in challenging situations involving competing interests and high level interdisciplinary groups.
- Excellent time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.
- Strong analytical and problem-solving skills.
- Knowledge of Texas Medicaid (STAR STAR Kids/CHIP) program National Committee for Quality
- Assurance (NCQA) the Uniformed Managed Care Contract and the Uniform Managed Care Manual.
- Sound business acumen.
- Proficient Microsoft Office and computer skills.
Benefits:
- Medical
- Dental
- Vision
- Life Insurance
- Disability Insurance
- Flexible Spending Accounts
- And more!
Requirement description :
By submitting your applicant to this need you are acknowledging that you have checked and have no inclination that your candidate has applied directly to this position. Any candidate that has applied directly is not eligible to be onboarded through an agency.
Experience:
- Five (5) years of management experience - Required.
- Eight (8) years of experience in Payment Integrity Audit and Recovery with knowledge of audit strategies such as Data Mining Clinical Medical Record Review and Bill Audit Recovery/Program Integrity experience - Strongly Preferred.
- 2 years of experience in a Managed Care health plan or state agency - Required.
- Knowledge of ICD-10 and CPT/HCPC coding guidelines and terminology - Required.
- Eight (8) years of experience in a comparable position working in Texas Medicaid or Medicaid Managed Care may be considered in lieu of a bachelor s degree.
- 5 Years of Texas Medicaid Managed Care Health Plan or State agency experience - Strongly Preferred.
Certification/Registration/Licensure
- Project management or Six Sigma certification - Strongly Preferred.
ADDITIONAL LICENSE REQUIREMENTS :
Weekend Requirements :
On Call Requirements :
Employment Type
Full-time
Key Skills
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