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Oregon Department of Human Services
Oregon Department of Human Services
ConsultingFood & BeverageHealthcare
The Oregon Department of Human Services is a state government agency supporting the health, safety, and well-being of people across Oregon. Its work spans child welfare, self-sufficiency services, and support for older adults and people with disabilities. The department collaborates with state agencies and community partners to deliver programs that help individuals, families, and communities meet essential needs. Its large public-service workforce contributes to the administration and delivery of social and human services throughout the state.
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Program Integrity Administrator Oregon Health Authority

Lead Oregon Health Authority’s statewide Medicaid program integrity strategy, including fraud prevention, compliance, audits, investigations, and provider oversight. Direct partnerships, budgets, policies, and multidisciplinary teams across a complex public health operation.

USUnited StatesOROregon
$9,604 – $14,856 / month
HybridFull-timeMiddleSeniorEnglish RequiredAdministration

Description

  • Direct statewide OHA operations addressing Medicaid program integrity, fraud, waste, abuse, and compliance
  • Establish priorities, policies, and performance goals aligned with OHA’s mission and applicable federal and state requirements
  • Lead multidisciplinary teams handling investigations, financial and compliance audits, data analytics, provider oversight, and Medicaid integrity work
  • Monitor emerging risks and trends and improve detection and investigation approaches
  • Apply operational data and insights to strengthen program integrity outcomes
  • Advise OHA leadership on relevant policy matters
  • Develop and sustain partnerships throughout Oregon and with federal stakeholders
  • Act as OHA’s principal liaison to CMS, federal oversight bodies, the Oregon Department of Justice Medicaid Fraud Control Unit, the Secretary of State, state agencies, contractors, providers, and community and industry organizations
  • Represent OHA on committees, task forces, and technical advisory groups
  • Deliver consultation, education, and technical assistance on Medicaid compliance and program integrity
  • Direct OPI budgets, contracts, staffing, strategic planning, and performance management
  • Oversee a complex program integrity portfolio within OHA’s approximately $21 billion annual operation
  • Make significant decisions independently within the scope of the role

Requirements

  • Five years of management experience, or two years of management experience plus a bachelor’s degree in a related field
  • Background or knowledge in fraud investigations, program integrity, regulatory compliance, or legal and administrative proceedings may be preferred
  • Experience leading or managing Medicaid program integrity, regulatory compliance, fraud, waste and abuse, audit, investigation, or oversight functions is preferred
  • Experience setting strategic direction, establishing priorities, defining performance goals, and leading complex programs or multidisciplinary teams is preferred
  • Experience managing or performing complex investigations, audits, risk assessments, data analysis, or related work is preferred
  • Experience collaborating with federal, state, local regulatory, oversight, law enforcement, or government organizations is preferred
  • Experience using audits, research, analytics, performance metrics, financial data, or other information to identify trends, evaluate risk, improve operations, and guide policy or management decisions is preferred
  • Ability to explain complex regulatory, financial, operational, or compliance matters to executive leaders and build effective stakeholder relationships is preferred
  • Employment requires a criminal records check that meets OHA criteria
  • Complete I-9 documentation and verify authorization to work in the United States within three days of hire
  • The position does not offer visa sponsorship; applicants must submit a resume and complete the supplemental questions
  • benefits

Benefits

  • Low-cost medical, vision, and dental coverage is available for employees and their families
  • Optional life insurance, disability insurance, deferred compensation, and health and childcare flexible spending accounts are available
  • 11 paid holidays
  • Three personal days
  • Monthly sick leave accrual
  • Vacation accrual beginning at eight hours per month
  • Possible eligibility for the Public Service Loan Forgiveness Program
  • Retirement coverage through PERS/OPSRP
  • Training and professional development opportunities
  • Hybrid and remote work flexibility

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