10/09/2025
🧠 Now Hiring: Director of Program Integrity – Medicaid Managed Care – $175K (Dallas, TX) 🏥
Join HELP-Hire Healthcare and lead Program Integrity for a renowned health system known for innovation, education, and research. Drive FWA (fraud, waste & abuse) prevention, optimize claims editing, and ensure payment accuracy across Medicaid Managed Care operations.
📍 Location: Dallas, TX
💰 Pay: $175,000/year
🕐 Schedule: Full-Time (Direct Hire)
🎁 Benefits: Medical, Dental, Vision, HSA, Life Insurance, EAP, PTO, Relocation Assistance
What You’ll Do:
- Lead Program Integrity strategy and day-to-day operations (claims editing, FWA prevention, payment accuracy)
- Oversee audits: data mining, clinical record review, and bill audit recovery
- Ensure compliance with Medicaid Managed Care requirements and coding standards (ICD-10, CPT/HCPC)
- Build, mentor, and align cross-functional teams; report outcomes to executive leadership
Requirements:
- 5+ years of management experience (Required)
- 8+ years in Payment Integrity Audit & Recovery with data mining and clinical/bill audit methods (Strongly Preferred)
- 5+ years in Texas Medicaid / Managed Care plan or state agency (Required)
- Deep knowledge of ICD-10 & CPT/HCPC; strong communication and problem-solving skills
- (Preferred) Central Sterile coursework is not applicable; instead, 8 years Texas Medicaid/Medicaid Managed Care in a comparable role may substitute for a bachelor’s degree
📢 Our HR team reviews resumes immediately—apply now for priority consideration!
🔗 Apply now: DM or email your resume to francisco@help-hire.com
🌐 Learn more: www.help-hire.com
