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Medicaid Program Integrity Jobs in Chicago, IL (NOW HIRING)

Pwc

Payer Quality Consultant, Director

Chicago, IL · On-site

$155K - $410K/yr

You are expected to be a guardian of PwC's reputation, understanding that quality, integrity ... Medicaid program requirements - Leading teams to generate a vision and trust - Building ...

Human Resources Development Inc

IM CANS Assessor

Chicago, IL · On-site

$15.50 - $21.25/hr

... Illinois Medicaid Comprehensive Assessment of Needs and Strengths (IM+CANS) assessments for ... Quality Assurance & Data Integrity * Participate in internal quality assurance activities ...

Friend Family Health Center

IM CANS Assessor

Chicago, IL · On-site

$15.50 - $21.25/hr

... Illinois Medicaid Comprehensive Assessment of Needs and Strengths (IM+CANS) assessments for ... Quality Assurance & Data Integrity * Participate in internal quality assurance activities ...

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All JobsMedicaid Program Integrity JobsMedicaid Program Integrity Jobs in Chicago, IL

Medicaid Program Integrity information

See Chicago, IL salary details

$22.1K

$47.1K

$64.9K

How much do medicaid program integrity jobs pay per year?

As of Aug 12, 2026, the average yearly pay for medicaid program integrity in Chicago, IL is $47,100.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,600.00 and $48,900.00 per year, depending on experience, location, and employer.

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.

How do I become a Medicaid Program Integrity specialist?

To become a Medicaid Program Integrity specialist, candidates typically need a bachelor's degree in health administration, public health, or a related field, along with experience in healthcare compliance or auditing. Relevant skills include knowledge of Medicaid policies, data analysis, and investigative techniques, and some roles may require certification such as Certified Fraud Examiner (CFE).
What are popular job titles related to Medicaid Program Integrity jobs in Chicago, IL? For Medicaid Program Integrity jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Chicago, IL look for? The top searched job categories for Medicaid Program Integrity jobs in Chicago, IL are:
What cities near Chicago, IL are hiring for Medicaid Program Integrity jobs? Cities near Chicago, IL with the most Medicaid Program Integrity job openings:
Medicaid Program Integrity jobs near you

Healthcare Compliance Manager

Vitae Health Systems

Park Ridge, IL • Hybrid

$115K - $130K/yr

Full-time

Re-posted 11 days ago

Job description

Description

Location: HYBRID; 2-3 days in Park Ridge, IL office

Compensation: The annual base salary range for this position is $115,000 - $130,000.

Job Description 

The Compliance Program Manager assists the VP Compliance in providing compliance oversight and establishing and maintaining an effective compliance program to promote awareness of, and compliance with, applicable laws, regulations, policies and standards.  

Core Responsibilities  

  • Assist in development of organizational compliance auditing/monitoring activities, including periodic reviews of the individual department auditing/monitoring functions; 
  • Ongoing management of the organization's Hotline and case management system; 
  • Assist in promotion of a corporate culture that fosters ethical and compliant behaviors and provides the basis for ensuring adequate controls to maintain compliance with law, regulations, and payer requirements throughout the organization.  
  • Interpret statutes, regulations, and regulatory communications for potential impact on the organization and its operations; 
  • Develop and implement policies, procedures, and practices designed to ensure compliance with the Office of Inspector General, Federal health care program requirements, and other applicable laws and regulations.   
  • Work closely with all departments for effective investigation, resolution, reporting, and remediation of compliance issues. Provide guidance to staff as appropriate to ensure departmental direction is effectively executed.
  • Manage medical record retrieval, review, and submission for CMS and government payer audits, ensuring timely and accurate responses.
  • Coordinate documentation requests for multiple CMS audit programs, including Recovery Audit Contractors (RAC), Targeted Probe and Educate (TPE), Unified Program Integrity Contractors (UPIC), Supplemental Medical Review Contractor (SMRC), Medicare Administrative Contractors (MAC), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), and Medicaid Integrity Contractors (MIC) audits.
  • Review clinical documentation to ensure compliance with Medicare, Medicaid, CMS, and payer-specific billing and documentation guidelines.   

Skills 

  • Knowledge of State and Federal laws and regulations that effect the provision of health care and health care organizations, including laws, regulations, policies, and requirements applicable to health systems including Medicare and Medicaid, insurance reimbursement, fraud and abuse laws, accreditation, licensing, and certification standards.   
  • Knowledge of ethics and compliance program elements, principles and practices, privacy, security, internal controls, and audit functions.   
  • Experience assessing compliance risk, interpreting, and applying applicable laws, regulations, policies, procedures, and professional practice standards for compliance and integrity programs.   
  • Highly analytical with strong attention to detail.   
  • Ability to multi-task in a fast-paced environment while maintaining an exemplary level of organization, productivity, and accuracy.   
  • Analytical skills and objective judgment to effectively manage problem resolution. Self-driven with excellent interpersonal and presentation skills.  
  • Excellent oral and written communication, organization, and time management skills.  
  • Knowledge of compliance investigation and auditing principles and standards.   
  • Proven ability to assess complex situations and prioritize multiple projects and demands. 

Requirements

  • Bachelor's degree and minimum of 3 years working experience in compliance in a healthcare setting. 
  • Certified in Healthcare Compliance (CHC) credential preferred.
  • Candidates who do not currently hold a CHC certification must be willing and able to obtain certification within six (6) months of hire. The Company will sponsor the certification process.

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