Integrity Management Services, Inc.

Program Manager

• Provide executive oversight and direction for program operations, ensuring performance aligns with contractual requirements, government guidance, and quality standards.
• Serve as a senior interface with government stakeholders, supporting governance, performance reviews, issue resolution, and risk management.
• Lead integrated teams and subcontractor partners to deliver efficient, compliant, and timely program outcomes.
• Oversee healthcare program integrity activities, including data-driven analysis, audits, oversight activities, and stakeholder communications.
• Ensure high-quality delivery of program outputs such as analytic reports, alerts, and external communications.
• Provide leadership for audit planning, execution, documentation, and corrective action processes.
• Oversee operational workflows for correspondence management, issue tracking, and responsiveness to external stakeholders.
• Lead coordination with related federal contractors and oversight entities to support aligned program execution and avoid duplication of effort.
• Support transition and implementation activities for new or expanding federal programs, ensuring continuity of operations.
• Ensure compliance with federal security, privacy, training, and records management requirements.

Director, Federal Health Program Operations

Capture Manager

• Lead capture efforts for assigned federal opportunities from identification through proposal kickoff
• Develop and execute Capture Plans, win strategies, and customer engagement plans
• Conduct customer, competitor, and incumbent intelligence analysis to shape positioning
• Partner with BD leadership to drive bid/no-bid decisions and pursuit prioritization
• Identify, negotiate, and manage teaming relationships with strategic industry partners
• Collaborate with operations, SMEs, and proposal teams to align solution development with customer needs
• Support responses to RFIs, Sources Sought, and other pre-solicitation activities
• Ensure IntegrityM enters proposal phase with clear win themes, discriminators, and solution readiness

Auditor

• Applies in-depth knowledge of federal and state regulations and healthcare industry standards.
• Comprehends and follows auditing plans and methodologies specific to contract requirements.
• Prioritization and assignment of workload, ensuring adherence to task order policies and procedures.
• Examines and calculates data from financial documents and statements such as provider cost reports as a method of audit.
• Utilize data mining and trend analysis tools to detect anomalies in Medicaid billing and payment patterns.
• Attend on-site audits to retrieve medical records and conduct provider entrance/exit conference.
• Prepare and submit medical record request letters to providers associated with requests for medical record requests or suspension overpayment determinations.
• Interpret and apply pertinent laws, regulations, policies, and procedures relevant to the specific audit findings and provider type being audited.
• Ensure Generally Accepted Government Auditing Standards (GAGAS) standards are applied to each applicable audit to identify fraud, waste or abuse.
• Preparing factual and objective written reports in conformance with professional auditing and evaluation standards and present findings to leadership, external agencies, and government partners.
• Calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.
• Prepare and send suspension overpayment determinations to providers when applicable.
• Communicates with federal/state agencies and providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.
• Attends briefings and presentations as assigned.
• Maintains fraud case development quality standards so that proper case development is ensured, and quality cases are fully prepared.
• Maintains proper and timely updates in appropriate tools and applications for their investigations. Case development databases and documents.
• Develops and documents reports of investigative findings, compiles case file documentation, calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.
• Program research relating to federal program applications, eligibility, payments, and other program requirements.
• Conducts on-site visits and/or interviews as required for investigation.
• Identify weaknesses in current audit processes and recommend enhancements for improved efficiency and effectiveness.
• Performs ad hoc tasks/duties as assigned.
• Ensures compliance with all applicable privacy and security training requirements (both IntegrityM and external/client-based), whether on an annual or ad/hoc basis. Please note: certain position levels (leads, managers, directors or higher) may require additional “role-based” training to ensure compliance with applicable privacy and security requirements.
• Exercises appropriate discretion and independent judgment relating to company policies and practices in an effective, consistent and professional manner.
• Adheres to applicable policies ensuring commitment to quality, compliance and security to protect the confidentiality, integrity, and availability of sensitive data and information.
• Adheres to all IntegrityM and/or client privacy and security protocols governing sensitive and/or business confidential information.

Medicaid Auditor III

Content Writer

• Work closely with the Marketing team, Business Development Team, Executive team, subject matter experts, and other IntegrityM personnel to produce winning content
• Responsible for creation, edits, and final review of proposed publications
• Will help manage marketing needs via Trello/other digital PM tools
• Gather necessary information from program personnel and research applicable policy, regulations, and best practices to support the team in developing, writing, formatting, and editing technical and non‐technical information for reports, white papers, blogs, marketing collateral, procedures, processes, briefs, and other forms of documentation
• Provide technical and editorial document review and written feedback on documents
• Maintain regular and frequent direct communication with subordinates to clearly articulate goals and priorities, and build trust and confidence
• Meet with proposal team to strategize win themes and proposal approaches
• Interview technical subject matter experts and develop written narrative from these interviews
• Write a variety of proposal sections, including executive summaries, technical approaches, management plans, and other content, and integrate proposal content authored by other writers into cohesive, compliant technical proposals with the flow of one voice
• Proofread and edit all work product: Review all proposals for consistent style and formatting according to company style guidelines. Ensure accurate spelling, punctuation, and grammar
• Stay informed of market developments in creative areas through reading, industry involvement, and research to determine competitive factors our company must address to stay viable and profitable

Director, Federal Health Program Operations

Capture Manager

Medicaid Auditor III

Proposal Writer, Editor