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Medicaid Program Integrity Jobs in Wisconsin (NOW HIRING)

Let'sGetChecked

WI · On-site

$240 - $270/hr

Promote a culture of ethics, integrity, accountability, and compliance across the organization ... Oversee compliance monitoring, auditing, and reporting programs to assess effectiveness and ...

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Medicaid Program Integrity information

What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?

AspectMedicaid Program IntegrityMedicaid Claims Examiner
Primary FocusDetecting and preventing fraud, waste, and abuse in Medicaid programsReviewing and processing Medicaid claims for accuracy and compliance
Required CredentialsTypically healthcare or compliance certifications, knowledge of Medicaid policiesHealthcare or claims processing certifications, attention to detail
Work EnvironmentRegulatory agencies, government offices, compliance departmentsInsurance companies, healthcare providers, government Medicaid offices

Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.

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For Medicaid Program Integrity jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Medicaid Program Integrity jobs in Wisconsin look for?

The top searched job categories for Medicaid Program Integrity jobs in Wisconsin are:

What cities in Wisconsin are hiring for Medicaid Program Integrity jobs?

Cities in Wisconsin with the most Medicaid Program Integrity job openings:

Medicaid Program Integrity jobs near you
Infographic showing various Medicaid Program Integrity job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

MDS Director - Full-Time 1st Shift

Lake Country Health Services

Summit, WI

$46/hr

Full-time

Re-posted 4 days ago

Job description

#LI-BW1

Now Hiring-MDS Director (RN)-up to $46/hr. (based on experience)

Lake Country Health Services - Oconomowoc, WI

Part of North Shore Healthcare


Supported MDS department with strong IDT collaboration and leadership.


Lake Country Health Services is seeking an experienced MDS Director (RN) to lead the assessment and reimbursement program in our respected skilled nursing center located in beautiful Lake Country / Oconomowoc.


This is an excellent opportunity for an experienced MDS professional who wants to practice at the top of their license in a center with strong interdisciplinary support and engaged leadership.


Lake Country Health Services is part of North Shore Healthcare, one of the largest post-acute providers in the Upper Midwest with 66 skilled nursing and assisted living centers across Wisconsin, Minnesota, and Michigan.



TEXT: MDS LAKE COUNTRY to (833) 381-4565 to apply.

Why MDS Nurses Choose Us?

       Supported MDS structure with strong interdisciplinary team collaboration

       Leadership that understands PDPM and reimbursement integrity

       Strong documentation culture supporting accurate MDS coding

       Regional clinical reimbursement resources and education

       Flexible scheduling options supporting work-life balance

       Stable organization with strong clinical leadership support


Role Overview

The MDS Director leads the Resident Assessment Instrument (RAI) process and ensures accurate and timely completion of resident assessments in accordance with Medicare, Medicaid, OBRA, and other payer requirements. This role works closely with nursing leadership, therapy, and administration to ensure assessments accurately reflect each resident's clinical condition while supporting regulatory compliance and reimbursement accuracy.


Key Responsibilities

       Lead and coordinate the MDS / RAI assessment process

       Chair the interdisciplinary care planning team

       Ensure accurate and timely MDS completion and submission

       Validate documentation supporting PDPM coding and reimbursement

       Monitor Medicare and Medicaid billing accuracy

       Provide staff education on documentation best practices

       Stay current with CMS and regulatory updates


Qualifications

Required

       Registered Nurse (RN) in good standing

       Experience with MDS / RAI and PPS assessments

Preferred

       2+ years MDS experience in skilled nursing or post-acute care


Our Culture

North Shore Healthcare operates under the values of Trust, Engagement, Competence, Respect, and Passion. Our teams are committed to delivering exceptional care while supporting professionals who want to grow, lead, and make a meaningful difference every day.

Apply