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Medicaid Program Integrity Jobs in Milwaukee, WI

Actalent

RN Care Manager

Milwaukee, WI · On-site

... integrity, and a strong commitment to quality. Responsibilities * Perform discipline-specific ... Knowledge of Medicare, Medicaid, and managed care programs, including BadgerCare and other ...

Actalent

RN Care Manager

Milwaukee, WI

... integrity, and a strong commitment to quality. Responsibilities * Perform discipline-specific ... Knowledge of Medicare, Medicaid, and managed care programs, including BadgerCare and other ...

GovernmentJobs.com

REIMBURSEMENT SPECIALIST

Racine, WI · On-site

$18 - $24.75/hr

Ensures the integrity of accounting information by recording, verifying, consolidating, and ... Ensure compliance with HIPAA, Medicaid, legal, regulatory, and coding requirements; communicate ...

City of Racine, WI

REIMBURSEMENT SPECIALIST

Racine, WI · On-site

$56K - $72K/yr

Ensures the integrity of accounting information by recording, verifying, consolidating, and ... Ensure compliance with HIPAA, Medicaid, legal, regulatory, and coding requirements; communicate ...

Meta House

Compliance Manager

Milwaukee, WI · On-site

... integrity, and accountability. Regulatory and Contractual Compliance Oversight * Ensure ... Design comprehensive and compliant training program for staff and leadership * Create awareness of ...

Meta House

Compliance Manager

Milwaukee, WI · On-site

... integrity, and accountability. Regulatory and Contractual Compliance Oversight * Ensure ... Design comprehensive and compliant training program for staff and leadership * Create awareness of ...

Consumer Direct companies

Care Coordinator

Waukesha, WI · On-site

$19.25 - $26/hr

Handle complex service programs and special projects * Lead, supervise and complete special ... We welcome your contributions and value your integrity as we collaborate on work that moves us all ...

Consumer Direct companies

Care Coordinator

Milwaukee, WI · On-site

$19 - $25.50/hr

Handle complex service programs and special projects * Lead, supervise and complete special ... We welcome your contributions and value your integrity as we collaborate on work that moves us all ...

CONSUMER DIRECT CARE NETWORK

Care Coordinator

Milwaukee, WI · On-site

$19 - $25.50/hr

Handle complex service programs and special projects * Lead, supervise and complete special ... We welcome your contributions and value your integrity as we collaborate on work that moves us all ...

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Showing results 21-40

All JobsMedicaid Program Integrity JobsMedicaid Program Integrity Jobs in Milwaukee, WI

Medicaid Program Integrity information

See Milwaukee, WI salary details

$21.2K

$45K

$62.1K

How much do medicaid program integrity jobs pay per year?

As of Aug 22, 2026, the average yearly pay for medicaid program integrity in Milwaukee, WI is $45,047.00, according to ZipRecruiter salary data. Most workers in this role earn between $36,900.00 and $46,800.00 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.

What are popular job titles related to Medicaid Program Integrity jobs in Milwaukee, WI?

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

What job categories do people searching Medicaid Program Integrity jobs in Milwaukee, WI look for?

The top searched job categories for Medicaid Program Integrity jobs in Milwaukee, WI are:

What cities near Milwaukee, WI are hiring for Medicaid Program Integrity jobs?

Cities near Milwaukee, WI with the most Medicaid Program Integrity job openings:

Medicaid Program Integrity jobs near you
Infographic showing various Medicaid Program Integrity job openings in Milwaukee, WI as of July 2026, with employment types broken down into 100% Full Time. Highlights an 46% In-person, and 54% Remote job distribution, with an average salary of $45,047 per year, or $21.7 per hour.

MDS Coordinator - Registered Nurse (RN)

The Village at Manor Park, Inc.

West Allis, WI • On-site

$40 - $50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

If you're driven by excellence in resident care and understand how accurate assessments directly impact outcomes and reimbursement, this role was designed for you.
We are seeking a Full-Time MDS Coordinator (RN) to play a critical role at the intersection of clinical care, compliance, and quality outcomes. In this position, you'll lead the completion of comprehensive resident assessments-ensuring accuracy, timeliness, and compliance with Medicare, Medicaid, OBRA, and other payer requirements. Working in close partnership with our interdisciplinary team, you'll ensure each assessment fully reflects the resident's physical, cognitive, and psychosocial status while supporting appropriate services and optimal reimbursement.
This is more than a documentation role-it's an opportunity to be a trusted clinical expert. If you're detail-oriented, collaborative, and passionate about compliance with purpose, you'll thrive here.
You'll join a supportive, interdisciplinary team where your expertise is valued, your voice is heard, and you're encouraged to mentor and elevate less experienced nursing staff while continuing to sharpen your own skills. If you're ready to make a meaningful impact every day, we'd love to meet you.
VMP Healthcare is dedicated to delivering comprehensive senior healthcare and community living services in alignment with our core values; Integrity, Respect, Compassion, Excellence, Teamwork, Community, and Fun.
Our vision is to spearhead the evolution of the senior living industry towards a dynamic future, driven by innovative and resident-focused clinical and administrative solutions.
We Offer a Competitive Wage and a Comprehensive Benefit Package to Eligible Employees that Includes:
Insurance (medical, dental, vision, life, short-term and long-term disability, accident and critical illness)
Flexible Spending Accounts and Health Savings Account
Educational Opportunities for career advancement
403b Retirement Plan and Roth IRA
Employee Assistance Program
Employee Referral Program
Paid Time Off
Full-Time
Onsite
1st shift
Monday through Friday
Compensation: $40-$50 per hour
Education Requirements:
  • Wisconsin RN License
  • Ideally at least 1 year of experience/training

Essential Functions of the Job:
RAI Process
  • Participates in pre-admission process to gather essential information for MDS/Case Mix optimization and recommends admission decisions, while collaborating with the Rehab Coordinator for accurate Medicare assessments.
  • Ensures timely and accurate completion of MDS assessments (initial, quarterly, and annual), collaborating with the interdisciplinary team, and addresses significant changes in status and modifications per CMS correction policies.
  • Coordinates and tracks Medicare PPS/OBRA assessments, provides staff training on reimbursement systems, stays updated on regulations, and ensures compliance with EHSI standards and state/federal guidelines.

Case Management:
  • Manages Medicare Part A and B certification/recertification, oversees communication with Managed Care, VA, and other payors, and ensures proper reimbursement by evaluating care from pre-admission to discharge.
  • Monitors compliance with Medicare, Medicaid, and other benefit programs, reviews documentation for accuracy, tracks claims denials, and assists with ADRs, reconsiderations, and ALJ hearings to ensure reimbursement and regulatory compliance.

Nursing Administration:
  • Communicates regularly with the D.O.N. and V.P./Administrator on clinical reimbursement issues, provides education to staff on coding and documentation, and supports orientation and training of employees.
  • Ensures compliance with safety standards, maintains professional development with ongoing CEUs, attends mandatory in-house education, and stays current in professional organizations related to subacute care.
  • Manages Medicare denial letters and appeals, oversees resident restorative programs in collaboration with therapists, and maintains a record of attendance and professional conduct according to facility standards.

What you can expect from us upon our receipt of your application:
  • HR will contact you within 1-2 business days of your application submission
  • Complete 1-2 interview(s) and meet with immediate supervisor and mentor
  • Upon receiving the job offer, complete onboarding paperwork through Paycor
  • Paid New-Hire Orientation
  • Continuous training from mentor

Apply