Hybrid - Director of Program Integrity (Payer-focused)
Company: Lancesoft INC
Location: Dallas
Posted on: January 29, 2026
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Job Description:
Job Description Job Description Hybrid - Director of Program
Integrity (Payer-focused) Full Time/Perm Days Hourly Range: Min
$61.06 Mid $82.45 Max $103.85 The Director of Program Integrity
provides leadership oversight and directs the operations for the
Program Integrity department and associated functions with focus on
claims editing, fraud, waste, and abuse (FWA) prevention, and
payment accuracy. Accountable for supporting Plan’s commitment to
operational excellence, cost containment, and adherence to state
and federal requirements. Will have to be onsite at least SIX DAYS
a month. Job Responsibilities: 1. Identifies and analyzes the
design of jobs, work processes, work flows, etc. for the area and
implements appropriate changes to improve effectiveness,
productivity, and efficiency that support the overall goals. 2.
Stays abreast of the latest developments, advancements, and trends
in the field by attending seminars/workshops, reading professional
journals, actively participating in professional organizations,
and/or maintaining certification or licensure. Integrates knowledge
gained into current work practices. 3. Maintains knowledge of
applicable rules, regulations, policies, laws and guidelines that
impact the area. Develops effective internal controls designed to
promote adherence with applicable laws, accreditation agency
requirements, and customer requirements. Seeks advice and guidance
as needed to ensure proper understanding. 4. Develops and monitors
annual budgets that ensure the department has the necessary funds
to carry out the goals and objectives that have been established
for the department. Benefits : Medical Dental Vision Life Insurance
Disability Insurance Flexible Spending Accounts And more!
Experience: Five (5) years of management experience - Required.
Eight (8) years of experience in Payment Integrity Audit and
Recovery with knowledge of audit strategies such as Data Mining,
Clinical Medical Record Review, and Bill Audit Recovery/Program
Integrity experience - Strongly Preferred. 2 years of experience in
a Managed Care health plan or state agency - Required. Knowledge of
ICD-10 and CPT/HCPC coding guidelines and terminology - Required.
Eight (8) years of experience in a comparable position working in
Texas Medicaid or Medicaid Managed Care may be considered in lieu
of a bachelor’s degree. 5 Years of Texas Medicaid, Managed Care
Health Plan or State agency experience - Required. Company
Description LanceSoft is rated as one of the largest staffing firms
in the US by SIA. Our mission is to establish global cross-culture
human connections that further the careers of our employees and
strengthen the businesses of our clients. We are driven to use the
power of our global network to connect businesses with the right
people, and people with the right businesses without bias. We
provide Global Workforce Solutions with a human touch. Company
Description LanceSoft is rated as one of the largest staffing firms
in the US by SIA. Our mission is to establish global cross-culture
human connections that further the careers of our employees and
strengthen the businesses of our clients. We are driven to use the
power of our global network to connect businesses with the right
people, and people with the right businesses without bias. We
provide Global Workforce Solutions with a human touch.
Keywords: Lancesoft INC, Keller , Hybrid - Director of Program Integrity (Payer-focused), Accounting, Auditing , Dallas, Texas
