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Medicare Medicaid Program Integrity Manager Jobs

Barrow Wise Consulting

Medicaid/Medicare Consultant

MD · On-site

$90K - $150K/yr

Provide and manage consulting, data transfer, and claims processing services to increase federal ... billing Medicare Part A & B and Medicaid programs; provide IDHS with detailed information ...

Imh

Medicaid Program Manager

Murray, UT · On-site +1

$44.99 - $69.44/hr

  • Medical

The Medicaid Program Manager reports to the Medicaid Program Director and is responsible for the administration, oversight, and strategic management of Medicaid programs and products. This role ...

HealthPartners

Payment Integrity Manager

Bloomington, MN · On-site

  • Medical

  • Retirement

... the Payment Integrity program. This role is responsible for designing and maintaining clear ... Working knowledge of Medicare, Medicaid, and Commercial reimbursement rules and regulatory ...

HHAeXchange

Sr. Program Integrity Analyst

Charleston, WV · Remote

$118K - $119K/yr

Present fraud findings and program integrity insights to state Medicaid agencies, managed care organizations, and internal stakeholders in formats that are clear, credible, and directly actionable.

HealthPartners

Payment Integrity Manager

Bloomington, MN · On-site

$51.85 - $77.77/hr

  • Medical

  • Retirement

... the Payment Integrity program. This role is responsible for designing and maintaining clear ... Working knowledge of Medicare, Medicaid, and Commercial reimbursement rules and regulatory ...

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Medicare Medicaid Program Integrity Manager information

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$38.5K

$107.5K

$157K

How much do medicare medicaid program integrity manager jobs pay per year?

As of Aug 15, 2026, the average yearly pay for medicare medicaid program integrity manager in the United States is $107,460.00, according to ZipRecruiter salary data. Most workers in this role earn between $79,500.00 and $132,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medicare Medicaid Program Integrity Manager?

To thrive as a Medicare Medicaid Program Integrity Manager, you need expertise in healthcare compliance, fraud detection, regulatory policy, and a bachelor's degree in healthcare administration or a related field. Familiarity with data analytics tools, case management systems, and regulatory databases such as CMS is typically required, along with certifications like Certified Professional in Healthcare Quality (CPHQ) or Certified Fraud Examiner (CFE). Strong analytical thinking, leadership, and effective communication skills are essential for coordinating investigations and collaborating with stakeholders. These skills and qualifications are crucial for upholding program integrity, minimizing fraud and abuse, and ensuring adherence to government healthcare regulations.

What does a Medicare Medicaid Program Integrity Manager do?

A Medicare Medicaid Program Integrity Manager is responsible for overseeing efforts to prevent, detect, and address fraud, waste, and abuse within Medicare and Medicaid programs. They develop and manage compliance strategies, conduct audits and investigations, and ensure that healthcare providers and beneficiaries follow federal and state regulations. Their work helps protect public funds and maintain the integrity of government healthcare programs.

How does a Medicare Medicaid Program Integrity Manager typically collaborate with compliance teams and federal auditors?

A Medicare Medicaid Program Integrity Manager regularly works alongside compliance teams to develop and implement processes that detect and prevent fraud, waste, and abuse in government healthcare programs. They also serve as a key liaison during audits and investigations conducted by federal agencies, ensuring that all requested documentation is accurate and submitted promptly. Frequent communication and coordination with both internal teams and external auditors are essential, as these partnerships help maintain program integrity and regulatory compliance.
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What cities are hiring for Medicare Medicaid Program Integrity Manager jobs?

Cities with the most Medicare Medicaid Program Integrity Manager job openings:

What states have the most Medicare Medicaid Program Integrity Manager jobs?

States with the most job openings for Medicare Medicaid Program Integrity Manager jobs include:

What job categories do people searching Medicare Medicaid Program Integrity Manager jobs look for?

The top searched job categories for Medicare Medicaid Program Integrity Manager jobs are:

Medicare Medicaid Program Integrity Manager jobs near you
Infographic showing various Medicare Medicaid Program Integrity Manager job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $107,460 per year, or $51.7 per hour.

Medicaid Compliance Subject Matter Expert (SME)

BerryDunn

Remote

$95K - $130K/yr

Full-time

Re-posted 11 days ago

Job description

Overview
BerryDunn is seeking a Medicaid Compliance Subject Matter Expert (SME). This position will provide expertise on federal and state Medicaid requirements, compliance monitoring, audit readiness, corrective action planning, risk mitigation, and the operational impacts of Medicaid enterprise systems and related workflows.
In this role, the Medicaid Compliance SME will work closely with cross-functional BerryDunn project teams, State stakeholders, Program Integrity staff, audit and TPL subject matter experts, data analysts, vendor partners, and project leadership to interpret requirements, assess risks, document processes, support system and operational improvements, and develop practical recommendations. The SME will help connect Medicaid policy, program operations, business process redesign, issue tracking, training, documentation, and change readiness activities so that project recommendations are actionable, compliant, and aligned our project priorities.
Travel expectations: This role may require travel up to 25% of the year.
You Will
  • Interpret Medicaid regulatory, Program Integrity, Third-Party Liability (TPL), Payment Error Rate Measurement (PERM), and compliance requirements relevant to the engagement.
  • Support compliance assessments, audit readiness activities, and documentation of risks and gaps.
  • Develop recommendations, corrective action approaches, and process improvements to address compliance findings.
  • Support responses to Centers for Medicare & Medicaid Services (CMS), state, or stakeholder requests related to Medicaid Program Integrity and Fraud, Waste, and Abuse (FWA) activities.
  • Support development and refinement of monitoring approaches, review protocols, documentation standards, and repeatable compliance review processes for Program Integrity, FWA, TPL, PERM, audit support, and corrective action activities.
  • Translate compliance findings, Medicaid policy interpretations, audit results, operational needs, and stakeholder feedback into practical recommendations for process updates, policy clarification, system considerations, vendor follow-up, training needs, or corrective action planning.
  • Support documentation quality, issue escalation, decision tracking, and follow-through for compliance, Program Integrity, audit, TPL, and FWA-related activities across the project.
  • Collaborate with policy, program, analytics, forensic, payment integrity, audit, TPL, vendor, and project leadership team members to align findings, prioritize follow-up activities, and coordinate recommendations.
  • Review policies, procedures, workflows, and operational materials for compliance considerations.
  • Support Medicaid system, policy, and operational improvement efforts by applying program knowledge to workflows, documentation, stakeholder needs, and business process redesign activities.
  • Identify and monitor compliance, operational, and system-related risks that may affect Program Integrity, TPL, PERM, FWA, audit support, policy alignment, or related Medicaid activities.
  • Assess the impact of federal and state Medicaid policy changes on operations, compliance activities, reporting, documentation, training, and system-supported workflows.
  • Support system enhancement, testing, implementation, and validation activities when compliance, program, reporting, or operational requirements intersect with Medicaid system changes.
  • Support onsite planning, compliance-related workgroup sessions, operational readiness discussions, and other project activities where Medicaid compliance, policy, or Program Integrity expertise is needed.
  • Support knowledge transfer, training, and readiness activities for Medicaid staff, project teams, or stakeholders related to compliance requirements, process changes, system workflows, and program integrity concepts.

You Have
  • Experience with Medicaid compliance, Program Integrity, TPL, PERM, audit response, or corrective action planning.
  • Strong policy interpretation, documentation, and risk assessment skills.
  • Experience working across operational, policy, analytical, and leadership stakeholders.

Preferred Qualifications/Experience:
  • Experience supporting Medicaid, health and human services, Program Integrity, TPL, PERM, audit response, FWA, or corrective action initiatives.
  • Experience working with Vendor-managed Medicaid systems, or similar public sector technology environments.
  • Experience supporting release readiness, system enhancement, testing, implementation, validation, operational readiness, or post-implementation follow-up.
  • Experience coordinating with cross-functional project teams, compliance SMEs, payment integrity SMEs, audit and TPL SMEs, training, operations, policy, vendor partners, and project leadership.
  • Minimum three (3) years of experience in a comparable Medicaid compliance, program integrity, audit, or consulting role preferred.

Compensation Details
The base salary range targeted for this role is $95,000-$130,000. This salary range represents BerryDunn's good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The salary of the finalist selected for this role will be based on a variety of factors, including but not limited to, years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations.
BerryDunn Benefits & Culture
Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what's expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn.
We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact careers@berrydunn.com to request an accommodation.
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.
About BerryDunn
BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm's tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm.
BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more at berrydunn.com.
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