Program Integrity Director: FWA Strategy & Compliance

Blue Cross and Blue Shield of Minnesota; Minneapolis, Saint Paul (MN, MN); Hybrid; USD 136,000 - 230,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

PTO

Job summary

Blue Cross and Blue Shield of Minnesota seeks a Program Director, Program Integrity to lead enterprise-wide strategy for Fraud, Waste, and Abuse prevention and detection. You will engage regulators, government agencies, and industry groups while driving analytics and governance across lines of business.

Ideal candidates bring 7+ years in program integrity, strong leadership, and the ability to translate insights into actionable organizational outcomes.

Qualifications

• 7+ years of related compliance/fraud, waste, and abuse (FWA) professional experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Responsibilities

• Develop and execute the enterprise Program Integrity strategy, aligning FWA initiatives with affordability goals, regulatory requirements, and organizational priorities.
• Develop and maintain relationships with regulators, law enforcement, and industry groups at state and national levels, including CMS, DHS, and the BCBS associations.
• Oversee enterprise FWA risk management, including prevention, detection, monitoring, governance, and continuous improvement of risk mitigation strategies.
• Provide strategic leadership for Program Integrity governance, including executive and board-level reporting, committee oversight, and organizational thought leadership.
• Ensure compliance with federal and state regulations, support audits and investigations, and maintain relationships with regulators and external stakeholders.
• Lead development of analytics, dashboards, KPIs, and reporting to measure program effectiveness, financial impact, savings, and risk exposure.

Skills

FWA expertise

Regulatory compliance

Stakeholder management

Cross-functional collaboration

Regulatory reporting

Education

Bachelor’s degree

Job description

Blue Cross and Blue Shield of Minnesota seeks a Program Director, Program Integrity to lead enterprise-wide strategy for Fraud, Waste, and Abuse prevention and detection. You will engage regulators, government agencies, and industry groups while driving analytics and governance across lines of business.

Ideal candidates bring 7+ years in program integrity, strong leadership, and the ability to translate insights into actionable organizational outcomes.