Administration

• Provide strategic leadership for OHA’s statewide program integrity, fraud, waste, and abuse (FWA), and Medicaid compliance operations
• Set priorities, develop policies and performance objectives, and ensure OPI operations support OHA’s mission, strategic goals, and federal and state requirements
• Lead a multidisciplinary team responsible for investigations, financial and compliance audits, data analytics, provider oversight, and Medicaid program integrity activities
• Identify emerging risks and trends and strengthen detection and investigation strategies
• Use data and operational insights to improve program integrity
• Provide policy guidance to OHA leadership
• Build and maintain partnerships across Oregon and at the federal level
• Serve as OHA’s primary liaison with CMS, federal oversight agencies, the Oregon Department of Justice Medicaid Fraud Control Unit, the Secretary of State, state agencies, contractors, providers, and community and industry partners
• Represent OHA in committees, task forces, and technical advisory groups
• Provide consultation, education, and technical assistance on Medicaid compliance and program integrity
• Oversee OPI’s budget, contracts, staffing, strategic planning, and performance management
• Manage a complex portfolio of program integrity activities within OHA’s approximately $21 billion annual operation
• Exercise significant independent decision-making authority
• Report directly to the Chief Financial Officer

Program Integrity Administrator

• Provide strategic leadership for OHA’s statewide program integrity, fraud, waste, abuse, and Medicaid compliance operations
• Set priorities, develop policies and performance objectives, and ensure OPI operations support OHA’s mission and federal and state requirements
• Lead a multidisciplinary team responsible for investigations, financial and compliance audits, data analytics, provider oversight, and Medicaid program integrity
• Identify emerging risks and trends and strengthen detection and investigation strategies
• Use data and operational insights to improve program integrity
• Provide policy guidance to OHA leadership
• Build and maintain partnerships across Oregon and at the federal level
• Serve as OHA’s primary liaison with CMS, federal oversight agencies, the Oregon Department of Justice Medicaid Fraud Control Unit, the Secretary of State, other state agencies, contractors, providers, and community and industry partners
• Represent OHA in committees, task forces, and technical advisory groups
• Provide consultation, education, and technical assistance on Medicaid compliance and program integrity
• Oversee OPI’s budget, contracts, staffing, strategic planning, and performance management
• Manage a complex portfolio of program integrity activities within OHA’s approximately $21 billion annual operation
• Exercise significant independent decision-making authority