1

Program Integrity Director Jobs in Rhode Island (NOW HIRING)

Director Payment Integrity

Providence, RI ยท On-site +1

$116K - $187K/yr

Oversee and direct programs that create a strong Payment Integrity program by developing/enhancing exiting vendor relationships and seeking new vendor relationships in alignment with the corporate ...

DIETITIAN - PRN

Providence, RI ยท On-site

$50/hr

... program integrity. The proper candidate will conduct business, at all times, with a clear ... Director, across a variety of platforms for health fairs, lunch and learns, programs launches ...

New

Plan, develop, organize, implement, evaluate, and direct the Maintenance Department, its programs ... Must be able to function independently and have flexibility, personal integrity, and the ability to ...

New

Plan, develop, organize, implement, evaluate, and direct the Maintenance Department, its programs ... Must be able to function independently and have flexibility, personal integrity, and the ability to ...

New

Admissions Director

Providence, RI ยท On-site

$85K/yr

... integrity-ensuring each family feels supported, informed, and confident in their decision to join ... Employee assistance program (EAP) resources Join our team at Elmhurst Rehabilitation and Healthcare ...

Admissions Director

Smithfield, RI ยท On-site

$60 - $85/hr

... integrity--ensuring each family feels supported, informed, and confident in their decision to join ... Employee assistance program (EAP) resources Join our team at Heritage Hills Rehabilitation and ...

Admissions Director

Smithfield, RI ยท On-site

$85K/yr

... integrity-ensuring each family feels supported, informed, and confident in their decision to join ... Employee assistance program (EAP) resources Join our team at Heritage Hills Rehabilitation and ...

Admissions Director

Smithfield, RI ยท On-site

$60 - $85/hr

... integrity--ensuring each family feels supported, informed, and confident in their decision to join ... Employee assistance program (EAP) resources Join our team at Heritage Hills Rehabilitation and ...

next page

Showing results 1-20

Program Integrity Director information

What is a program integrity director?

Program Integrity Directors are responsible for overseeing and ensuring the compliance, effectiveness, and accountability of organizational programs, often within government agencies or large organizations. They develop and implement policies to prevent fraud, waste, and abuse, and they monitor program operations to ensure adherence to regulations and standards. Program Integrity Directors often lead teams, conduct audits, and collaborate with other departments to promote transparency and ethical practices. Their work is crucial for maintaining public trust and ensuring resources are used appropriately.

What are some typical challenges faced by a program integrity director, and how can they be addressed?

Program Integrity Directors often face challenges such as navigating complex regulatory requirements, detecting and preventing fraud, and ensuring compliance across multiple departments or partners. Addressing these requires strong analytical skills, clear communication, and effective collaboration with legal, compliance, and operational teams. Staying updated on industry best practices and fostering a culture of transparency can also help mitigate risks and support program goals.

What are the key skills and qualifications needed to thrive as a program integrity director, and why are they important?

To thrive as a Program Integrity Director, you need expertise in compliance, risk management, regulatory analysis, and a relevant degree such as in business administration, public policy, or law. Familiarity with data analytics tools, case management systems, and certifications like Certified Fraud Examiner (CFE) or Certified Internal Auditor (CIA) are often important. Strong leadership, ethical judgment, and effective communication skills are crucial for building trust and guiding teams through complex investigations. These skills ensure the organization maintains regulatory compliance, prevents fraud, and promotes operational transparency.

What is the difference between Program Integrity Director vs Claims Manager?

AspectProgram Integrity DirectorClaims Manager
Required CredentialsBachelor's degree, certifications in healthcare compliance or auditingBachelor's degree, experience in claims processing or insurance
Work EnvironmentHealthcare or insurance organizations, compliance departmentsInsurance companies, healthcare payers, claims processing units
Employer & Industry UsageUsed in healthcare, government programs, insurance sectorsPrimarily in insurance companies and healthcare payers

The Program Integrity Director focuses on ensuring compliance, preventing fraud, and maintaining program integrity within healthcare or insurance organizations. In contrast, Claims Managers oversee the processing and adjudication of insurance claims. While both roles require knowledge of healthcare or insurance operations, the Program Integrity Director emphasizes compliance and fraud prevention, whereas the Claims Manager concentrates on claims processing efficiency and accuracy.

What are popular job titles related to Program Integrity Director jobs in Rhode Island?

For Program Integrity Director jobs in Rhode Island, the most frequently searched job titles are:

What job categories do people searching Program Integrity Director jobs in Rhode Island look for?

The top searched job categories for Program Integrity Director jobs in Rhode Island are:

What cities in Rhode Island are hiring for Program Integrity Director jobs?

Cities in Rhode Island with the most Program Integrity Director job openings:

Infographic showing various Program Integrity Director job openings in Rhode Island as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 21% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

IMPLMNT DIR-POLICY & PROGRAMS

RI Council 94

Providence, RI โ€ข On-site

$114 - $131/hr

Other

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Department Executive Office of Health and Human Services Division Project/Program Management Salary $114,174.00 - $131,189.00 Job Profile JC-02500500-99 - Implementation Director - Policy & Programs (Non-Union Executive Branch) Scheduled Work Days & Work Hours Monday - Friday, 8:30am - 4:00pm 35 Hours - Non-Standard Job Requisition Number JR103530 IMPLMNT DIR-POLICY & PROGRAMS (Open) Pay Grade C00140 A Classification Implementation Director - Policy & Programs Class Definition


GENERAL STATEMENT OF DUTIES

To be responsible for the development, implementation and administration of broad policies and programs that affect all areas for the efficient operation of all departments of state government. SUPERVISION RECEIVED: Works under the administrative direction of a superior with wide latitude in the exercise of independent initiative and judgement; work is subject to review through conferences and written reports for satisfactory performance and conformance with prescribed policies and procedures. SUPERVISION EXERCISED: To plan, coordinate and supervise the work of a staff as required.


ILLUSTRATIVE EXAMPLES OF WORK PERFORMED

To be responsible for the development, implementation and administration of broad policies and programs that affect all departments of state government for their more efficient operation. To coordinate reorganization of major services to ensure a smooth and efficient transition. To assist in establishing policy and program priorities in relation to short and long range goals and objectives. To assist in a program of studies in order to develop comprehensive approaches towards the effective utilization of economic and human resources. To perform or otherwise coordinate evaluations and auditing processes to determine results of programs instituted in the areas of: annual savings, increased revenues, improved cost controls, cost avoidances, and other efficiencies and economic results. To be responsible for the continuing monitoring of programs and services instituted for management and financial impact over the long term. To prepare written reports as required regarding the results of various policies and programs instituted. To establish and maintain effective working relations with all departmental officials. To do related work as required.


REQUIRED QUALIFICATIONS FOR APPOINTMENT

KNOWLEDGES, SKILLS AND CAPACITIES: A thorough knowledge of the modern principles and practices of all phases of general administration; a thorough knowledge of administrative planning, programming, direction and evaluation of organizational structures of state government and the functions of its departments and agencies; the ability to identify problems and establish priorities and goals in the improvement of management of state government operations; the ability to establish and maintain effective working relationships with state and other officials; and related capacities and abilities. EDUCATION AND EXPERIENCE: Education: Such as may have been gained through: possession of a Master of Science Degree in an administrative specialty; and Experience: Such as may have been gained through: at least 5 years of employment in a responsible supervisory and administrative capacity with ultimate responsibility for the development, implementation, and administration of efficient policy and programming. Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.


SUPPLEMENTAL INFORMATION

Within the Medicaid Office of Program Integrity, supporting provider enrollment and auditing functions. This position will conduct audits of internal enrollment files as well as provider audits to ensure compliance with state and federal requirements. This position will also assist with representing the agency at administrative hearings related to provider sanctions and terminations resulting from Program Integrity actions. Preferred experience in compliance and auditing and/or legal experience. https://www.everify.gov/sites/default/files/everify/posters/IER_RighttoWorkPoster.pdf https://everify.uscis.gov/web/media/resourcesContents/EVerify_Participation_Poster_ES.pdf The individual hired to fill this position will have access to Federal tax Information (FTI), as defined in IRS Publication 1075, and, as such, must undergo a national fingerprint background screening in accordance with the set forth in regulation 220-RICR-40-00-2 (IRS Publication 1075 โ€“ Background Check Process and Criteria available at https://rules.sos.ri.gov/regulations/part/220-40-00-2. Additionally, the individual is being hired to an E-Verify site which contains FTI and must have their employment eligibility validated through E-Verify.


BENEFITS

For information regarding the benefits available to State of Rhode Island employees, please visit the Office of Employee Benefits' website at http://www.employeebenefits.ri.gov/. Also, be advised that a new provision in RI General Law 35-6-1 was enacted requiring direct deposit for all employees. Specific to new hires, the law requires that all employees hired after September 30, 2014 participate in direct deposit. Accordingly, any employee hired after this date will be required to participate in the direct deposit system. At the time the employee is hired, the employee shall identify a financial institution that will serve as a personal depository agency for the employee.


STATE OF RHODE ISLAND JOBS

The State of Rhode Island is committed to providing fundamental services to all Rhode Islanders. Join our team and enjoy the benefits of providing public service with purpose and impact. The State of Rhode Island provides reasonable accommodations to qualified individuals with disabilities throughout the application and hiring process. If you need a reasonable accommodation to participate in any part of the process, please contact hr.talent@hr.ri.gov.

#J-18808-Ljbffr