Program Director overseeing contract requirements and operations for Medicare and Medicaid in the Midwestern Region. Ensuring compliance, quality assurance, and stakeholder communication for federal health agency.
Responsibilities
Oversight of contract requirements and jurisdictional operations
Lead, manage, and support a team
Ensure appropriate staffing and resource allocation
Maintain effective communication with internal staff and external stakeholders
Ensure compliance with contract requirements including quality, cost control, and timeliness
Implement and maintain a quality assurance program
Submit timely and accurate monthly cost reports and corrective action plans as needed
Ensure timely and quality submission of deliverables and ad hoc requests
Maintain superior business relations with CMS, Law Enforcement, MACs, and other partners
Requirements
Bachelor's degree with 20 years of professional experience OR Master’s degree with 15 years of professional experience
At least eight years in healthcare, Medicare, Medicaid, or related private insurance field
Minimum of seven years in a progressive management capacity with responsibility for managing complex systems and workflows
US Citizenship is required
Must be able to obtain Public Trust clearance
Intensive experience conducting and overseeing healthcare fraud investigations for healthcare payers and/or law enforcement
Customer familiarity with the CMS Center for Program Integrity (CPI)
Expertise in the Medicare program and the CMS/CPI’s fraud, waste, and abuse workflow
Credentials such as: Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AFHI), or similar
Proficiency in MS Office Applications (Word, PowerPoint, Outlook, Excel, Project) and MS SharePoint.
Talent Development Program Manager at Hewlett Packard Enterprise creating and managing talent programs. Partnering with HR to align strategies in Puerto Rico and beyond.
Program Manager overseeing operational activities for Growth & Transformation at Acuity Inc. Supporting project managers and ensuring operational excellence for the organization's strategy.
Senior Program Manager leading and managing strategic initiatives at F5 for business growth and innovation. Collaborating with cross - functional teams and providing mentorship to ensure program success.
Tariff Program Analyst at BD managing tariff mitigation and import programs across North America. Ensuring compliance and operational efficiency by collaborating with various teams.
Substance Use Program Manager overseeing compliance of treatment and recovery services at the Vermont Department of Health. Collaborating with organizations to ensure adherence to state and federal guidelines.
Principal Program Manager for Enterprise GIS managing modernization programs at PG&E. Driving large - scale projects and fostering innovation across business units and external partners.
Principal Program Manager managing Estimating training program at PG&E and leading strategic initiatives. Collaborating with stakeholders and guiding training towards compliance and effectiveness.
Program Manager in aerospace sector at GKN Aerospace managing allocated programs and customer relations. Ensuring compliance with business cases and achieving financial targets.
Principal Program Manager managing patient journeys through clinical trials at Immatics. Coordinating with medical professionals and cross - functional teams to optimize patient pathways.
Program Management Executive leading complex technology programs within a regulated financial institution. Driving transformational change and delivering excellence across Global Technology team.