Program Integrity Specialist

Job Posting Important Recruitment Information for this vacancy Job Posting closes: April 28, 2026 Required documents uploaded by: April 28, 2026 Kansas Department of Health and Environment Our agency is led by Secretary Janet Stanek, who was appointed by Gov. Kelly in Dec 2021. KDHE is comprised of three divisions: Public Health, Environment, and Health Care Finance (which includes the State's Medicaid program, KanCare). We are the only agency in the nation to have these three entities under one roof which allows us to take a holistic approach to improving and protecting the health and well-being of all Kansans. Verification of identity and employment eligibility to work in the United States is required by federal law. For a list of acceptable documents that establish these criteria, please refer to the federal Form I-9. KDHE does not provide sponsorships for this position. E-Verify: Kansas Department of Health and Environment (KDHE) participates in E-Verify and will provide the federal government with your I-9 information to confirm that you are authorized to work in the U.S. For additional information regarding E-Verify, please click here. For additional information regarding Immigrant and Employee Rights (IER) please click here. http://www.kdhe.ks.gov/ About the Position Who can apply: Anyone (External). Classified/Unclassified Service: Unclassified Full-Time/Part-Time: Full-Time Regular/Temporary: Regular Work Schedule: Monday-Friday, 8am-5pm (Flexible schedules available) Eligible to Receive Benefits: Yes Veterans' Preference Eligible: Yes Sponsorship: KDHE does not provide sponsorship for this position. Compensation Hourly Pay Range: $20.13 - $23.31 Salary can vary depending upon education, experience, or qualifications. Employment Benefits Comprehensive medical, mental, dental, vision, and additional coverage Sick & Vacation leave Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave Paid State Holidays (designated by the Governor annually) Fitness Centers in select locations Employee discounts with the STAR Program Retirement and deferred compensation programs Visit the Employee Benefits page for more information… Position Summary & Responsibilities Position Summary The Program Integrity Specialist position (K0221996) monitors and directs implementation of FFS utilization reviews of services provided to Medicaid consumers by selected providers. Reviews are completed by fiscal agent medical and policy analysts including RNs. Manages subsequent corrective action activities as determined when inadequacies or weaknesses are identified by fiscal agent utilization management (UM) provider reviews. Impose sanctions on providers based on case reviews and investigations for the purpose of eliminating improper utilization of Medicaid funds. Assists the KDHE legal counsel in preparation of agency utilization, review appeals and testifies on behalf of the agency as necessary. Manages fiscal agent SURS unit to direct resources where needed including oversight of assistance of MCO activity. Works daily with the KanCare MCO's compliance and program integrity teams regarding contract requirements, including but not limited to: participation in annual desk reviews and on-site audits; review of applicable program integrity policies; facilitation of monthly meetings; and review and approval of monthly and quarterly program integrity reports. Job Responsibilities may include but are not limited to the following Works jointly with the Medicaid Fraud Control Unit (MFCU) and KS OIG in a mutually supportive manner in an effort to reduce or prosecute provider fraud. Gathers and provides supportive documentation and acts as liaison between MFCU, KS OIG and KDHE staff and contractors to provide referrals for potentially fraudulent activity in the Medicaid program to the Attorney General's office for investigation and prosecution. Manages referrals from MFCU or KS OIG for appropriate administrative action. Qualifications Education: High School, GED Licensing & Certification: Valid Driver's License - Incumbent is required to have and maintain a valid driver's license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State. Minimum Qualifications: Must live within 1-2-hour travel time from/to Topeka, KS. This position must work in the office as determined by the Director. One year of experience in planning, organizing, preforming, and administrating the work of a department, program or agency. Education may be substituted for experience as determined relevant by the agency. Two years' experience in healthcare or the health insurance field (Medicaid, provider relations, member services or Fraud, Waste and Abuse efforts) Two years of Medicaid, clinical or healthcare administration roles that deals frequently with the public may be substituted for the required experience. Word, Excel, PowerPoint, Access Proofreading, editing, attention to detail Independent Judgment Advanced Problem Solving and Analytical Skills Communicate effectively both verbally and in writing Knowledge of proper English, spelling and grammar Preferred Qualifications: Four years direct experience in Political Science, Public Administration, Business or a relatable field. Knowledge/interpret Medicaid rules and regulations Provide excellent customer service Analyze data and present in clear and concise reports Previous Medicaid experience and/or previous program integrity experience Previous Medicaid experience and experience with SURS and program integrity activities Experience with the Office 365 Post-Offer, Pre-employment Requirements: Kansas Tax Clearance Certificate: A valid Kansas Tax Clearance Certificate is a condition of employment for all employees of the State of Kansas. Applicants (including non-residents) who receive a formal job offer for a State job, are required to obtain a valid Tax Clearance within ten (10) days of the job offer. A Tax Clearance can be obtained through the Kansas Department of Revenue who reviews individual accounts for compliance with Kansas Tax Law. If you have a missing tax return(s) or you owe taxes to the State of Kansas, please know that the Kansas Department of Revenue will work with you. The Kansas Department of Revenue can set you up on a payment plan to receive a Tax Clearance so you can get a job working for the State of Kansas. The Kansas Department of Revenue can be contacted at 785-296-3199. Kansas Department of Revenue - Tax Clearance Frequently Asked Questions Recruiter Contact Information Name: Whitney Uthe Email: Whitney.Uthe@ks.gov Mailing Address: 1000 SW Jackson St. Suite 580 Topeka, KS 66612 Job Application Process First Sign in or register as a New User. Complete or update your contact information on the Careers> My Contact Information page. *This information is included on all your job applications. Upload required documents listed below for the Careers> My Job Applications page. *This information is included on all your job applications. Start your draft job application, upload other required documents, and Submit when it is complete. Manage your draft and submitted applications on the Careers> My Job Applications page. Check your email and My Job Notifications for written communications from the Recruiter. Email - sent to the Preferred email on the My Contact Information page Notifications - view the Careers> My Job Notifications page Helpful Resources at jobs.ks.gov: "How to Apply for a Job - Instructions" and "How to Search for a Job - Instructions" Required Documents for this Application to be Complete Upload these on the Careers - My Job Applications page Transcripts DD214 (if you are claiming Veteran's Preference) Upload these on the Attachments step in your Job Application Resume Cover Letter Helpful Resources at jobs.ks.gov: "How, What, & Where do I Upload Documents" How to Claim Veterans Preference Veterans' Preference Eligible (VPE): Former military personnel or their spouse that have been verified as a "veteran"; under K.S.A. 73-201 will receive an interview if they meet the minimum competency factors of the position. The veterans' preference laws do not guarantee the veteran a job. Positions are filled with the best qualified candidate as determine by the hiring manager. Learn more about claiming Veteran's Preference How to Claim Disability Hiring Preference Applicants that have physical, cognitive and/or mental disabilities may claim an employment preference when applying for positions. If they are qualified to meet the performance standards of the position, with or without a reasonable accommodation, they will receive an interview for the position. The preference does not guarantee an applicant the job, as positions are filled with the best qualified candidate as determined by the hiring manager. Learn more about claiming Disability Hiring Preference PLEASE NOTE: The documentation verifying a person's eligibility for use of this preference should not be sent along with other application materials to the hiring agency but should be sent directly to OPS. These documents should be sent either by fax to (785)296-7712, scanned and emailed to Gustavo.Victoriano@ks.gov, or can be mailed/delivered in person to: ATTN: Disability Hiring Preference Coordinator Office of Personnel Services Landon State Office Building 900 SW Jackson, Rm 401 Topeka, KS 66612 Equal Employment Opportunity The State of Kansas is an Equal Opportunity Employer. We value diversity, equity, and inclusion as essential elements that create and foster a welcoming workplace. All qualified persons will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, political affiliation, disability or any other factor unrelated to the essential functions of the job. If you wish to identify yourself as a qualified person with a disability under the Americans with Disabilities Act and would like to request an accommodation, please address the request to the agency recruiter.