Head of Programme Management
Jobgether
This position is listed on behalf of a partner company, which manages all applications and next steps. The Manager – Program Integrity plays a key role in protecting the integrity, quality, and effectiveness of healthcare and human services programs. This position oversees investigative teams, monitors operational performance, and develops strategies to prevent and detect fraud, waste, and abuse. Working across enterprise contracts, the role combines strategic oversight with hands-on investigation and risk management. You will collaborate with government agencies, regulatory bodies, and internal stakeholders to strengthen compliance and improve program outcomes. As an independent leader, you will also mentor and develop teams while contributing to transparent, accountable, and high-quality service delivery.
\Lead and oversee investigative teams, ensuring compliance with applicable laws, regulations, contractual obligations, and internal policies while prioritizing investigations and addressing emerging fraud schemes.
Identify, assess, and mitigate risks to program integrity by developing and implementing effective fraud prevention, detection, and monitoring strategies.
Monitor operational performance metrics, evaluate existing processes, and implement continuous improvement initiatives to enhance efficiency, effectiveness, and service quality.
Direct advanced investigations into suspected fraud, misconduct, waste, abuse, and non-compliance, coordinating appropriate corrective actions and follow-up measures.
Oversee targeted and strike force reviews, intelligence-driven targeting activities, and other investigative initiatives to identify and address program vulnerabilities.
Collaborate with internal departments, government agencies, regulatory bodies, and external partners to promote transparency, accountability, and consistent compliance practices.
Maintain accurate documentation of investigative activities, program performance, and compliance outcomes, preparing regular reports and communicating key findings to relevant stakeholders.
Provide guidance and training to program staff on compliance requirements, investigative procedures, and program integrity best practices.
Manage team performance through ongoing feedback, formal performance evaluations, coaching, and professional development initiatives that support engagement and high-quality service delivery.
Support senior leadership with contract operations, administrative responsibilities, and strategic initiatives that strengthen the overall performance of the Program Integrity division.
Bachelors degree required, with relevant professional experience potentially considered as a substitute, depending on the positions requirements.
8–11 years of relevant experience required, with 12–14 years preferred, particularly in program integrity, healthcare compliance, fraud investigations, risk management, or related fields.
Strong understanding of applicable laws, regulations, compliance frameworks, investigative procedures, and fraud prevention practices within healthcare or human services programs.
Demonstrated ability to conduct complex investigations, identify potential fraud schemes, assess risks, evaluate evidence, and implement effective corrective actions.
Proven ability to supervise investigative teams, manage performance, provide constructive feedback, and develop a motivated, high-performing workforce.
Strong skills in interpreting performance metrics, identifying operational weaknesses, assessing program effectiveness, and translating findings into actionable improvement strategies.
Ability to manage competing priorities, oversee multiple activities, maintain accurate records, and ensure consistent adherence to established standards.
Certified Fraud Examiner (CFE) or Accredited Healthcare Anti-Fraud Investigator (AHFI).
Remote work:
Home-based, remote position within the United States, subject to the employers location and eligibility requirements.
Opportunities to strengthen expertise in healthcare compliance, fraud prevention, risk management, and investigative leadership.
Contribute to protecting healthcare and human services programs by helping prevent fraud, waste, and abuse while supporting accountability and quality of service delivery.
Work with multidisciplinary teams and external stakeholders, including government and regulatory organizations.
Healthcare coverage, retirement plans, paid time off, and other employee benefits may be available; We use an
AI-powered matching process
to ensure your application is reviewed quickly, objectively, and fairly against the roles core requirements. The final decision and next steps (interviews, assessments) are managed by their internal team.
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Reference: 4487_21730145