Director of Program Integrity - Lead Fraud, Waste & Abuse Prevention for a Major Health Plan Job at KA Recruiting Inc., Plano, TX

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  • KA Recruiting Inc.
  • Plano, TX

Job Description

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.

Job Tags

Full time, Monday to Friday, Flexible hours, Shift work, Weekday work,

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