Program Director - Jurisdiction

Please note: This role is contingent upon a contract award. While it is not an immediate opening, we are actively conducting interviews and extending offers in anticipation of the award.  

Jurisdiction Program Director Position (onsite, Midwestern Region) 

ICF is currently seeking a Jurisdiction Program Director to oversee contract requirements and overall operations within the Midwestern Region for a federal health agency. Under this program, ICF will investigate potential fraud, waste, and abuse in Medicare and Medicaid programs. The Program Director will fulfill its contract requirements to protect the integrity of these healthcare programs by coordinating activities to ensure appropriate staffing, effective communication with internal and external stakeholders, and compliance with contract requirements including quality, cost control, timeliness, and business relations. The Program Director will also ensure the implementation of a robust quality assurance program and maintain superior business relations with CMS, Law Enforcement, MACs, and other stakeholders. 
 

The successful candidate should have extensive experience in healthcare, Medicare, Medicaid, or related private insurance fields, with a strong background in managing complex systems and workflows. The candidate must demonstrate effective leadership, communication, and organizational skills, and be capable of managing high-level stakeholder relationships and contract deliverables. 
 

Job Location- Preference given to Midwest-based candidates. Remote role with up to 50% travel, mainly to Baltimore, MD and the Midwest (Midwestern Region includes Minnesota, Wisconsin, Illinois, Indiana, Michigan, Ohio, Kentucky, Iowa, Missouri, Nebraska, and Kansas.) 
 

Key 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. 

Basic Qualifications: 

• Bachelor’s degree with 20 years of professional experience OR Master’s degree from an accredited institution with 15 years of professional years 

• 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 by the federal government for this position  

• Must be able to obtain Public Trust clearance. 

Preferred Qualifications: 

• 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. 

Professional Skills: 

• Strong leadership and organizational skills. 

• Excellent verbal and written communication skills. 

• Proven ability to manage complex projects and meet deadlines. 

• Ability to foster positive relationships with stakeholders and team members.