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Program Integrity Director Jobs in Baltimore, MD

State of Maryland

PROGRAM MANAGER IV

Baltimore, MD · On-site

$99K - $156K/yr

FAMLI is seeking a Director of Program Integrity to lead the program's fraud prevention efforts and safeguard the FAMLI Trust Fund. As state benefit programs across the country are increasingly ...

GDR Defense

Program Director

Baltimore, MD · On-site

Join us to make a difference, advance your career, and grow with a company that values integrity, diversity, and continuous improvement. Job Title: Program Director Agency: City of Baltimore Location:

State of Maryland

PROGRAM MANAGER SENIOR IV

Baltimore, MD · On-site

$150K - $203K/yr

Responsible for directing programs within the division that have a broad scope and major impact on ... Program Integrity, Digital Services, Policy and Public Engagement, Performance Management ...

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All JobsProgram Integrity JobsProgram Integrity Director JobsProgram Integrity Director Jobs in Baltimore, MD

Program Integrity Director information

See Baltimore, MD salary details

$29.3K

$77.7K

$136.1K

How much do program integrity director jobs pay per year?

As of Aug 18, 2026, the average yearly pay for program integrity director in Baltimore, MD is $77,698.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,700.00 and $91,900.00 per year, depending on experience, location, and employer.

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 Baltimore, MD?

For Program Integrity Director jobs in Baltimore, MD, the most frequently searched job titles are:

What job categories do people searching Program Integrity Director jobs in Baltimore, MD look for?

The top searched job categories for Program Integrity Director jobs in Baltimore, MD are:

What cities near Baltimore, MD are hiring for Program Integrity Director jobs?

Cities near Baltimore, MD with the most Program Integrity Director job openings:

Program Integrity Director jobs near you

Deputy Center Director (Medicaid Program Integrity)

Centers for Medicare & Medicaid Services

Woodlawn, MD • On-site, Remote

$151K - $228K/yr

Full-time

Posted 6 days ago

Job description

Summary
This position is located in the Center for Program Integrity (CPI) at the Centers for Medicare & Medicaid Services (CMS).
As the Deputy Center Director (Medicaid Program Integrity), you will provide executive leadership, direction and coordination for the management of a cohesive, agency-wide approach to ensuring program integrity across the Medicaid and Children's Health Insurance Program (CHIP).
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Duties
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  • Provides executive leadership and expert knowledge for the agency as it relates to Medicaid program integrity (PI) activities.
  • Directs the identification of program vulnerabilities and actions taken to formulate and implement methodologies to strengthen program integrity efforts emerging with fraud, waste, and abuse in the Medicaid and CHIP programs.
  • Provides strategic direction and oversight for CPI's engagement with State Medicaid agencies on program integrity activities, including the review and approval of State program integrity plans and corrective action plans.
  • Directs CPI's oversight of program integrity activities within Medicaid Managed Care Organizations (MCOs), including the review of encounter data, claims data, and managed care contract compliance.
  • Oversees CPI strategic planning, as well as the establishment of performance goals and measures for CPI and its staff.
  • Provides guidance to ensure appropriate liaison and coordination with the Department, other HHS Operating Divisions, other Federal agencies and other non-Federal organizations necessary to CPI's program integrity operations.

Requirements
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Conditions of employment
  • Must be a U.S. Citizen or National.
  • Subject to a 1-year supervisory probationary period (unless already completed).
  • Complete a Declaration for Federal Employment to determine your suitability for Federal employment, at the time requested by the agency.
  • If you are a male applicant born after December 31, 1959, certify that you have registered with the Selective Service System or are exempt from having to do so.
  • May be subject to pre-employment and random drug tests.
  • You may be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal.
  • The Ethics in Government Act, PL 95-521 requires the applicant selected for this position to submit a financial disclosure statement, OGE-278e, prior to assuming the SES position, annually, and upon termination of employment.
  • Status applicants must submit a copy of their most recent SF-50, Notification of Personnel Action, which verifies status.
  • All initial appointments to an SES position are contingent on approval from OPM's Qualifications Review Board unless the selectee has successfully participated in an OPM approved SES Candidate Development Program.
  • Only experience obtained by the closing date of this announcement will be considered.

Qualifications
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin.
To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position.
There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs).
TECHNICAL QUALIFICATIONS (TQs): Your resume should demonstrate accomplishments that would satisfy the technical qualifications.
TQ 1: Demonstrated executive-level experience leading national program integrity efforts for Medicaid, the Children's Health Insurance Program (CHIP), or similar Federal health care programs. This includes developing and leading strategies to prevent, detect, and address fraud, waste, abuse, and improper payments; overseeing nationwide provider oversight and enforcement activities; coordinating audits, investigations, and corrective actions with Federal and State agencies, State Medicaid Fraud Control Units (MFCUs), and law enforcement partners; and achieving measurable results that improved program integrity, strengthened accountability, or reduced improper payments across the country.
TQ 2: Demonstrated executive-level experience integrating program integrity into enterprise strategy, policy development, and national operational frameworks for Medicaid, the Children's Health Insurance Program (CHIP), or comparable Federal health care programs. This includes identifying gaps in statutory, regulatory, or policy frameworks; developing and implementing policy, regulatory, or operational solutions to address emerging risks and program vulnerabilities; aligning program integrity initiatives with agency-wide strategic planning, budget priorities, and legislative proposals; and advising senior leadership on program integrity strategy, risk management, and national policy direction.
EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position.
There are five ECQs:
  • ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people.
  • ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades.
  • ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality.
  • ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable.
  • ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors.

Note: If you are a member of the SES or have been certified through successful participation in an OPM-approved SES Candidate Development Program (SESCDP) or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES.
Education
This job does not have an education qualification requirement.
Additional information
Veterans' Preference: Veterans' preference is not applicable to the SES.
Mobility:Organizational and geographical mobility is essential in developing and managing SES leaders. Individuals selected for SES positions may be subject to reassignment across geographical, organizational, and functional lines, and may be required to sign a Reassignment Rights and Obligation Agreement.
Equal Employment Opportunity (EEO) Policy Statement: http://www.eeoc.gov/federal/index.cfm
Employment Information Resources - Resource Center: https://help.usajobs.gov/how-to
Males born after 12-31-1959 must be registered or exempt from Selective Service (see https://www.sss.gov/RegVer/wfRegistration.aspx)
OPM must authorize any employment offers made to current or former (within the last 5 years) political Schedule A, Schedule C, or Non-career SES employees in the executive branch. If you are currently, or have been within the last 5 years, a political Schedule A, Schedule C, or Noncareer SES employee in the executive branch, you must disclose that to the Human Resources Office.
Salary for SES positions varies depending on qualifications. The annual salary range is found at the top of this announcement. The selectee for this position may be eligible for annual performance bonuses and performance-based pay adjustments.
This position is designated as a Testing Designated Position (TDP). You must successfully complete a pre-employment urinalysis drug screening. You will be subject to unannounced random drug testing for the duration of service in this position.
Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Benefits
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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

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