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

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.