Program Director – WTC Health Program (COB & Recovery Program)

Position Summary
The Program Director serves as the primary leadership and management point of contact for a large-scale federal healthcare program focused on cost avoidance, coordination of benefits (COB), and claims recovery. This role is responsible for overseeing contract performance, ensuring operational excellence, and maintaining strong relationships with federal stakeholders and program partners.

Key Responsibilities

• Serve as the primary liaison between the organization and the WTC Health Program, including communication with Program Management, Contracting Officer (CO), and Contracting Officer Representative (COR)

• Provide end-to-end oversight of contract operations, ensuring all deliverables meet quality, timeliness, and compliance standards

• Lead execution of a comprehensive cost avoidance, COB, and recovery program across pre- and post-payment processes

• Ensure accurate and timely submission of reports, deliverables, and ad hoc requests

• Oversee implementation and adherence to a robust quality assurance program

• Manage cross-functional teams supporting:

  • Insurance identification and verification

  • Coordination of benefits (COB)

  • Claims recovery (OHI & Workers’ Compensation)

  • Payment integrity and fraud, waste, and abuse (FWA) efforts

• Maintain effective communication channels with internal staff and external stakeholders, including government entities and program partners

• Drive performance monitoring, operational improvements, and cost containment strategies

• Ensure compliance with federal regulations, HIPAA requirements, and contractual obligations

• Foster and maintain strong business relationships with all program stakeholders

Required Qualifications

• Minimum 10+ years of experience in:

  • Coordination of Benefits (COB)

  • Claims recovery / payment integrity

  • Federal healthcare program management

• Proven experience managing large, complex government contracts or programs

• Strong knowledge of:

  • Healthcare claims processing

  • Insurance coordination (OHI, Workers’ Compensation)

  • Payment integrity and recovery operations

• Demonstrated leadership experience managing cross-functional teams and stakeholders

• Experience ensuring contract compliance, reporting accuracy, and SLA performance

• Excellent communication and stakeholder management skills

Preferred Qualifications

• Experience working with federal health programs (e.g., CMS, CDC, or similar)

• Familiarity with data analytics, fraud detection platforms, and recovery systems

• Experience in healthcare cost containment and program integrity initiatives

Work Environment

• 100% remote/offsite, with occasional travel (estimated 4+ trips annually)

• Travel may include Washington, DC; New York City; Cincinnati; Atlanta

Why This Role Matters

This role plays a critical part in improving healthcare efficiency and cost control for a federally mandated program serving 9/11 responders and survivors. The Program Director ensures financial integrity while maintaining high-quality care delivery.