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Medicaid Program Integrity Jobs in Rosedale, MD (NOW HIRING)

C-HIT

Data Analyst - 4

Columbia, MD · On-site

... Medicaid, or federal healthcare programs. * Knowledge of HL7 FHIR and healthcare data standards. * Knowledge of CMS CPI systems like PECOS; APS. * Understanding of CMS Medicare Program Integrity ...

Maryland Physicians Care

Manager, Care Manager

Linthicum, MD · On-site +1

$106K - $117K/yr

With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care ... Ensures that program integrity and regulatory requirements are met in conjunction with the Director ...

eSimplicity

Test Automation Engineer III

Columbia, MD · On-site

$97K - $98K/yr

Validate data sourced from CMS's Integrated Data Repository (IDR) and OnePI (Program Integrity ... Prior experience supporting Centers for Medicare & Medicaid Services (CMS) programs. * Experience ...

eSimplicity

Test Automation Engineer III

Columbia, MD · On-site

$97K - $98K/yr

Validate data sourced from CMS's Integrated Data Repository (IDR) and OnePI (Program Integrity ... Prior experience supporting Centers for Medicare & Medicaid Services (CMS) programs. * Experience ...

eSimplicity

Test Automation Engineer III

Columbia, MD · On-site

$97K - $98K/yr

Validate data sourced from CMS's Integrated Data Repository (IDR) and OnePI (Program Integrity ... Prior experience supporting Centers for Medicare & Medicaid Services (CMS) programs. * Experience ...

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Showing results 21-40

All JobsMedicaid Program Integrity JobsMedicaid Program Integrity Jobs in Rosedale, MD

Medicaid Program Integrity information

See Rosedale, MD salary details

$20.6K

$43.9K

$60.4K

How much do medicaid program integrity jobs pay per year?

As of Aug 10, 2026, the average yearly pay for medicaid program integrity in Rosedale, MD is $43,853.00, according to ZipRecruiter salary data. Most workers in this role earn between $36,000.00 and $45,600.00 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 job categories do people searching Medicaid Program Integrity jobs in Rosedale, MD look for? The top searched job categories for Medicaid Program Integrity jobs in Rosedale, MD are:
What cities near Rosedale, MD are hiring for Medicaid Program Integrity jobs? Cities near Rosedale, MD with the most Medicaid Program Integrity job openings:
Medicaid Program Integrity jobs near you
Infographic showing various Medicaid Program Integrity job openings in Rosedale, MD as of August 2026, with employment types broken down into 100% Full Time. Highlights an 33% In-person, and 67% Remote job distribution, with an average salary of $43,853 per year, or $21.1 per hour.

Data Analyst - 4

C-HIT

Columbia, MD • On-site

Full-time

Medical, Life, Retirement, PTO

Re-posted 14 days ago

Job description

Key Responsibilities:

Data Architecture & Design

  • Design and maintain enterprise data architecture for structured and semi-structured healthcare data.
  • Define logical, conceptual, and physical data models.
  • Establish data standards, naming conventions, and metadata management practices.
  • Support event-driven and API-based data architectures.
  • Align data architecture with CMS interoperability mandates (FHIR, HL7).

Data Analysis & Insights

  • Analyze large healthcare datasets to identify patterns, trends, and anomalies.
  • Support fraud, waste, and abuse (FWA) detection efforts through data analysis.
  • Develop analytical datasets and data marts for reporting and investigations.
  • Partner with business stakeholders to translate requirements into data solutions.

API & Streaming Integration

  • Support data design for API Gateway integrations (MuleSoft or similar).
  • Ensure data consistency across Kafka streaming pipelines and batch sources.
  • Define data contracts and schemas for real-time data exchange.
  • Validate data transformations and mappings across source and target systems.

Data Governance & Quality

  • Implement data governance, lineage, and stewardship practices.
  • Monitor and improve data quality, accuracy, and completeness.
  • Support data audits, validations, and remediation efforts.
  • Ensure compliance with HIPAA, CMS, FISMA, and NIST standards.

Reporting & Visualization

  • Design and support reports, dashboards, and analytics for program integrity and operations.
  • Support ad-hoc data requests from investigators and oversight teams.

Collaboration & Documentation

  • Work closely with architects, developers, QA, and security teams.
  • Participate in Agile ceremonies and data design reviews.
  • Maintain comprehensive documentation of data models, mappings, and architecture decisions.

Required Qualifications:

  • Bachelor’s degree in Computer Science, Data Science, Information Systems, or related field.
  • 5+ years of experience in data architecture and/or data analysis.
  • Strong experience with data modeling (ER, dimensional, normalized models).
  • Proficiency in SQL and data analysis techniques.
  • Experience working with large enterprise data environments.

Preferred Qualifications:

  • Experience supporting CMS, Medicaid, or federal healthcare programs.
  • Knowledge of HL7 FHIR and healthcare data standards.
  • Knowledge of CMS CPI systems like PECOS; APS.
  • Understanding of CMS Medicare Program Integrity Manual.
  • Experience with API-driven data integration (MuleSoft preferred).
  • Familiarity with Kafka or streaming data platforms.
  • Experience with cloud data platforms like AWS.

Key Skills:

  • Data Architecture & Modeling
  • Healthcare Data & Interoperability
  • Fraud Analytics & Data Validation
  • API & Streaming Integration
  • Data Governance & Quality
  • Federal Compliance Standards

Residency Requirement:

Must be eligible to obtain and maintain a Public Trust clearance. In accordance with federal background investigation requirements, candidates must have physically resided in the United States for at least three (3) of the preceding five (5) years.

Salary & Benefits Information:

  • The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience, and location.
  • C-HIT offers Healthcare Benefits, Remote Working Options, Paid Time Off, PTO cash-out, Training/Certification opportunities, Healthcare Savings Account & Flexible Savings Account, Paid Life Insurance, Short-term & Long-term Disability, 401K Match & Profit sharing, Employee Assistance Program, Paid Holidays, and much more perks and Voluntary benefits!
  • Employees of C-HIT shall, as an enduring obligation throughout their term of employment, adhere to all information security requirements as documented in company policies and procedures.

C-HIT, a CMMI Maturity Level 5 company, focuses on delivering information technology and professional services to Federal and State agencies.

"C-HIT is an EOE, including disability and veterans”