Program Integrity Strategy Director

Blue Cross & Blue Shield of Minnesota; Eagan (MN); Hybrid; USD 136,000 - 230,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Life insurance

401k

PTO

Volunteer Paid Time Off

Job summary

Blue Cross and Blue Shield of Minnesota is seeking a Program Director, Program Integrity to lead enterprise strategy, governance and outcomes for fraud, waste, and abuse prevention and detection across lines of business. This executive role partners with regulators, law enforcement, and industry groups to advance analytics and clear accountability.

The position drives cross-functional collaboration to strengthen controls, measure program effectiveness with dashboards and KPIs, and ensure

Qualifications

• 7+ years of related compliance/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 fraud, waste, and abuse (FWA) initiatives with affordability goals, regulatory requirements, and organizational priorities.
• Develop and maintain relationships with appropriate regulators, law enforcement, and industry groups.
• 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, industry organizations, law enforcement, and government stakeholders.
• Lead development of analytics, dashboards, KPIs, and reporting to measure program effectiveness, financial impact, savings, and risk exposure while translating insights for executive leadership.

Skills

FWA experience

Regulatory compliance

Stakeholder engagement

Analytics & dashboards

Leadership

Education

Bachelor's degree

Master's degree preferred

Job description

Blue Cross and Blue Shield of Minnesota is seeking a Program Director, Program Integrity to lead enterprise strategy, governance and outcomes for fraud, waste, and abuse prevention and detection across lines of business. This executive role partners with regulators, law enforcement, and industry groups to advance analytics and clear accountability.

The position drives cross-functional collaboration to strengthen controls, measure program effectiveness with dashboards and KPIs, and ensure