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Program Integrity Analyst Jobs (NOW HIRING)

BerryDunn

Program Integrity Lead

Analyze claims data, audit results, program integrity reports, recovery information, and related documentation to identify risks, trends, findings, and improvement opportunities. * Develop or update ...

New

BerryDunn

Analyze claims data, audit results, program integrity reports, recovery information, and related documentation to identify risks, trends, findings, and improvement opportunities. * Develop or update ...

CVS Health

Program Integrity Manager

New York, NY

$54K - $145K/yr

Position Summary The Program Integrity Manager serves as a key leader supporting Medicaid Program ... Strong analytical, organizational, communication, and problem-solving skills. * Ability to manage ...

Ventura County, CA

Revenue Integrity Analyst

Ventura, CA · On-site

$91K - $128K/yr

Under the general direction of the Revenue Integrity Manager, the incumbent performs advanced analytical, consultative, and project leadership work to support the County's Revenue Integrity Program.

Uw

Revenue Integrity Analyst

Olympia, WA · On-site

$122K/yr

... INTEGRITY ANALYST WORK SCHEDULE 100% FTE Weekdays 100% Remote DEPARTMENT DESCRIPTION UW Medicine ... Programs, Specialty Clinic, and Urology. This includes, but not limited to, knowledge and ...

Lee Health

Revenue Integrity Analyst

Cape Coral, FL · On-site

$22.78 - $29.62/hr

... Integrity Analyst position for Professional Billing will be involved in assisting the newly ... Requirements Educational Requirements Degree/Diploma Obtained Program of Study Required/ Preferred ...

Ernest Health

Revenue Integrity Analyst

Mesquite, TX · On-site

We are seeking a Revenue Integrity Analyst to join our Billing Office team! As a participating ... These programs focus to enhance the employees' work experience, recognize, and celebrate ...

Lee Health

Revenue Integrity Analyst

Cape Coral, FL

$22.78 - $29.62/hr

... Integrity Analyst position for Professional Billing will be involved in assisting the newly ... Requirements Educational Requirements Degree/Diploma Obtained Program of Study Required/ Preferred ...

Ascension

Revenue Integrity Analyst

Pensacola, FL · Remote

$72K - $100K/yr

Lead data analysis teams by writing advanced SQL queries and developing functional reporting design ... E-Verify statement Employer participates in the Electronic Employment Verification Program. Please ...

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Program Integrity Analyst information

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$37K

$89.2K

$131.5K

How much do program integrity analyst jobs pay per year?

As of Jul 28, 2026, the average yearly pay for program integrity analyst in the United States is $89,153.00, according to ZipRecruiter salary data. Most workers in this role earn between $69,000.00 and $116,000.00 per year, depending on experience, location, and employer.

What is the difference between Program Integrity Analyst vs Claims Analyst?

AspectProgram Integrity AnalystClaims Analyst
Required CredentialsBachelor's degree, certifications in healthcare or compliance often preferredBachelor's degree, knowledge of insurance policies and claims processing
Work EnvironmentHealthcare or government agencies, compliance departmentsInsurance companies, healthcare providers, or third-party administrators
Employer & Industry UsageUsed in healthcare, government programs, Medicaid/MedicareCommon in insurance, healthcare billing, and claims processing

Program Integrity Analysts focus on ensuring compliance, detecting fraud, and maintaining program integrity within healthcare and government programs. Claims Analysts primarily handle processing, reviewing, and managing insurance claims. While both roles require understanding of healthcare policies and compliance, Program Integrity Analysts emphasize fraud detection and regulatory adherence, whereas Claims Analysts concentrate on claims processing and customer service.

What are some common challenges faced by Program Integrity Analysts, and how can they be addressed?

Program Integrity Analysts often encounter challenges such as detecting complex fraud patterns, managing large datasets, and staying updated with changing regulations. To address these issues, analysts typically use advanced data analytics tools and participate in ongoing training to remain current with industry standards. Building strong cross-functional relationships with compliance, legal, and IT teams also helps to streamline investigations and implement effective corrective actions.

What are the key skills and qualifications needed to thrive as a Program Integrity Analyst, and why are they important?

To thrive as a Program Integrity Analyst, you need strong analytical abilities, attention to detail, and a background in auditing, compliance, or data analysis, often supported by a relevant bachelor’s degree. Familiarity with data analysis tools like Excel, SQL, and specialized compliance software, as well as knowledge of regulations such as HIPAA or Medicaid/Medicare policies, is typically required. Strong problem-solving, communication, and critical thinking skills help you identify discrepancies, interpret complex data, and collaborate with stakeholders. These competencies are essential for accurately detecting fraud or errors, ensuring regulatory compliance, and protecting organizational resources.

What are Program Integrity Analysts?

Program Integrity Analysts are professionals who evaluate and monitor programs, typically within government agencies or healthcare organizations, to ensure compliance with laws, regulations, and internal policies. Their main goal is to detect, prevent, and address fraud, waste, and abuse within these programs. They analyze data, conduct audits, investigate anomalies, and recommend improvements to enhance program efficiency and integrity. These analysts play a crucial role in safeguarding public resources and maintaining trust in institutional processes.
More about Program Integrity Analyst jobs
What job categories do people searching Program Integrity Analyst jobs look for? The top searched job categories for Program Integrity Analyst jobs are:
Program Integrity Analyst jobs near you
Infographic showing various Program Integrity Analyst job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 88% Full Time, 6% Part Time, 1% Temporary, and 4% Contract. Highlights an 83% Physical, 7% Hybrid, and 10% Remote job distribution, with an average salary of $89,153 per year, or $42.9 per hour.
Medicaid/Medicare Program Integrity Analyst II

Medicaid/Medicare Program Integrity Analyst II

CoventBridge Group

Remote

$58K - $70K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

CoventBridge Group rating

6.7

Company rating: 6.7 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

302nd of 488 rated business services

Job description

Overview
Medicaid/Medicare Program Integrity Analyst II - REMOTE
The Medicaid/Medicare Program Integrity Analyst II performs evaluation and development of leads, complaints, and/or investigations to verify allegations of potential fraud. Recommends and/or implements appropriate administrative actions.
In assuming this position, you will be a critical contributor to meeting CoventBridge Integrity Systems' objective: To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse.
This position will report directly to the Program Integrity Supervisor and will work in our Grove City, OH office, or if not local, remotely from a home office.
Responsibilities/ Requirements
Responsibilities:
  • Perform evaluation and development of leads, complaints, and/or investigations to determine if further investigation and administrative actions are warranted
  • Conduct independent reviews resulting from the discovery of situations that potentially involve fraud or abuse
  • Utilize basic data analysis techniques to detect aberrancies in Medicare and Medicaid claims data, and proactively seeks out and develops leads/investigations received from a variety of sources (e.g., CMS, OIG, 1-800-MEDICARE, and fraud alerts)
  • Review information contained in standard claims processing system files (e.g., claims history, provider files) to determine provider billing patterns and to detect potential fraudulent or abusive billing practices or vulnerabilities in Medicare and Medicaid policies and initiate appropriate action
  • Make potential fraud determinations by utilizing a variety of sources such as internal guidelines, Medicare and Medicaid provider manuals, Medicare and Medicaid regulations, and the Social Security Act
  • Compile and maintain documentation and information related to investigations, cases, and/or leads
  • Participate in onsite audits in conjunction with investigation development
  • Develop and prepare potential Fraud Alerts and program vulnerabilities for submission to CMS. Share information on current fraud investigations with other Medicare contractors and state Medicaid agencies, law enforcement, and other applicable stakeholders
  • Prepare and submit external correspondence and reports, including, but not limited to, overpayment letters, fraud case referrals, suspensions, rebuttals, Medicare/Medicaid findings reports, and administrative action recommendations
  • Submit suspension notifications to providers upon suspension approval
  • Prepare and submit ADR letters to providers associated with requests for medical record requests or suspension overpayment determinations
  • Serve as mentor/trainer to new Program Integrity staff
  • Perform other duties as assigned by PI Supervisor or PI Manager that contribute to task order goals and objectives

Requirements:
  • Excellent research and organization, prioritization, and time management skills
  • Excellent verbal and written communication skills
  • Ability to work independently with minimal supervision
  • Ability to multi-task in a fast-paced environment
  • Knowledge of statistics, data analysis techniques, and PC skills are preferred

Educational/Experience Qualifications:
  • High School Diploma or G.E.D. equivalent, with preference given to those candidates who have successfully completed college or technical degree programs related to the position (e.g., Criminal Justice, Statistics, Data Analysis, etc.)
  • Candidates with Certified Fraud Examiner (CFE) Certifications will be given priority consideration
  • At least 1 year of experience in Program Integrity investigation/detection or a related field that demonstrates expertise in reviewing, analyzing/developing information, and making appropriate decisions

Benefits
  • Medical, Dental, Vision plans
  • Life, LTD and STD paid by the employer
  • 401(k) with company match up to 4%
  • Paid Time Off and company paid holidays
  • Tuition assistance after 1 year of service

The salary range for this role is $58,000 to $70,000 annually. This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
At this time, CoventBridge is not considering candidates who require visa sponsorship, currently or in the future, including but not limited to H-1B, H-2B, E-3, TN, O-1, F-1 (OPT/CPT, or J-1 Visa Statuses.)
About Us:
CoventBridge Integrity Systems delivers investigative services, technology, and expertise that help healthcare and government organizations protect critical programs, strengthen oversight, and address fraud, waste, abuse, and operational risk.
CoventBridge Integrity Systems is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.
CoventBridge Integrity Systems is committed to the full inclusion of all qualified individuals. As part of this commitment, CoventBridge Integrity Systems will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.

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