Director of Program Integrity – Lead Fraud, Waste & Abuse Prevention for a Major Health Plan

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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.
Location:
Plano
Job Type:
FullTime
Category:
Healthcare & Medical

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