Administrator for Program Integrity
Core
Strategic leadership for statewide Medicaid program integrity, fraud, waste, and abuse (FWA), and compliance operations.
Role type
Senior executive administrator (program integrity)
Builds
Strategic direction, policies, and performance objectives for a multidisciplinary team handling investigations, audits, and provider oversight.
Domain
Public sector healthcare administration / Medicaid compliance
Required skills
Strategic leadership, Medicaid program integrity management, fraud investigation oversight, state and federal regulatory collaboration, data-driven program management, executive communication
Preferred skills
Advanced fraud investigation and legal proceedings experience, court representation, complex negotiation
Technologies
None explicitly stated
Responsibilities
Setting priorities and developing policies for program integrity operations; leading a multidisciplinary team in investigations and audits; serving as primary liaison with CMS and federal/state agencies; overseeing budget, contracts, and staffing; identifying emerging risks and trends in Medicaid FWA.
Seniority
Senior, strategic leadership