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.
Warranty Program Manager at Dematic improving end - to - end warranty process and collaborating with cross - functional teams. Driving efficiency and customer satisfaction through strategic ownership and data analysis.
Program Manager overseeing new field leadership development program at JE Dunn Construction. Ensuring successful execution and coordination of training across multiple sites.
Programme Manager coordinating delivery for the Network squad in Relay's logistics company. Managing dependencies, roadmaps, and ensuring stakeholders are informed across teams in a hybrid setup.
Experienced Program Manager leading Salesforce transformations for clients at Sand Cherry Associates. Driving execution and operational support while managing multiple workstreams and stakeholders.
Program Manager overseeing named Enterprise Services accounts. Responsible for project management and operational oversight to ensure customer satisfaction with service delivery.
HEDIS Program Manager responsible for quality improvement activities at BCBSMA. Collaborating with various teams and analyzing healthcare metrics to enhance performance measures.
Senior Program Manager overseeing Value - Based Care programs at Blue Cross NC. Collaborating with teams to maintain program performance and manage risks while ensuring operational integrity and accountability.
Strategic Cost Program Manager leading cost optimization and operational excellence for Gaming Solutions. Driving cross - functional programs to deliver cost savings and margin improvement.
Program Management Analyst authoring Program Direction Letters at Ford. Collaborating with engineering, marketing, and manufacturing teams to influence vehicle delivery.
Sr Program Manager leading programs and ensuring cost, schedule, and technical performance for space systems at Sierra Space. Collaborating with cross - functional teams to drive program management success.