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Program Integrity Director Jobs in Elgin, IL (NOW HIRING)

ULINE

Director of Benefits

Glenview, IL · On-site

Director of Benefits Corporate Headquarters 12575 Uline Dr. Pleasant Prairie, WI 53158 Lead and ... Ensure compliance with regulations while supporting reporting, audits and program integrity.

Bcbsa

Director, Payment Integrity

Chicago, IL · On-site

The Director, Payment Integrity serves as BCBSA's enterprise leader for advancing a System-wide ... BlueCard Payment Integrity Program * Serve as the business owner for BCBSA's effort to integrate ...

Rush

AVP Pharmacy Business & Outcomes

Chicago, IL

$192K - $286K/yr

... • Direct contracting strategies with pharmaceutical manufacturers, wholesalers, and GPOs to ... Ensure program integrity through alignment with federal/state regulations and RUSH compliance ...

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All JobsProgram Integrity JobsProgram Integrity Director JobsProgram Integrity Director Jobs in Elgin, IL

Program Integrity Director information

See Elgin, IL salary details

$29.2K

$77.3K

$135.4K

How much do program integrity director jobs pay per year?

As of Jun 14, 2026, the average yearly pay for program integrity director in Elgin, IL is $77,297.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,400.00 and $91,400.00 per year, depending on experience, location, and employer.

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 Program Integrity Directors?

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 popular job titles related to Program Integrity Director jobs in Elgin, IL? For Program Integrity Director jobs in Elgin, IL, the most frequently searched job titles are:
What job categories do people searching Program Integrity Director jobs in Elgin, IL look for? The top searched job categories for Program Integrity Director jobs in Elgin, IL are:
What cities near Elgin, IL are hiring for Program Integrity Director jobs? Cities near Elgin, IL with the most Program Integrity Director job openings:
Program Integrity Director jobs near you
Director, Healthcare - Payment Integrity

Director, Healthcare - Payment Integrity

West Monroe

Chicago, IL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 17 days ago

Job description

Are you ready to make an impact?
Healthcare Payment Integrity Director
West Monroe has an immediate opportunity for a Director aligned to the Healthcare Practice. This role will focus on delivering business and technology consulting solutions for payer organizations, with a specialization in Payment Integrity, claims operations, reimbursement methodologies, and healthcare finance transformation.
Working alongside leaders across our National Healthcare Practice, this role will be responsible for developing and growing client relationships, identifying and pursuing new business opportunities, leading complex consulting engagements, and delivering exceptional value to clients. Candidates should be passionate about healthcare transformation, client service, and working in a collaborative, entrepreneurial environment.
Client Development
  • Develop and expand relationships with payer organizations, including medical and ancillary insurers.
  • Serve as a trusted advisor to client executives by bringing deep expertise in Payment Integrity, claims processing, reimbursement recovery, and provider revenue cycle operations.
  • Identify and originate opportunities within existing and prospective client accounts.
  • Participate in business development activities including client meetings, industry events, networking, and proposal development.
  • Support the sales cycle by helping shape solutions, work plans, pricing approaches, and value propositions.
  • Leverage market insights and industry expertise to position West Monroe as a trusted advisor and thought leader.
  • Collaborate with Healthcare Practice leadership, Business Development, and Marketing teams to support go-to-market activities and client growth initiatives.
  • Contribute to account growth through cross-selling and expansion of existing client relationships.
Client Delivery
  • Serve as an engagement leader on Payment Integrity and payer transformation engagements.
  • Manage all aspects of client delivery including scope, budget, staffing, workstreams, deliverables, and overall engagement profitability.
  • Provide strategic and operational guidance to clients on Payment Integrity programs, claims operations, reimbursement methodologies, and recovery optimization.
  • Communicate project status, risks, recommendations, and outcomes to executive stakeholders.
  • Ensure value creation is identified, measured, and articulated throughout the engagement lifecycle.
  • Mentor and develop consulting teams while maintaining high standards of quality and client service.
  • Act as a point of escalation for client concerns and drive issues through resolution.
  • Apply deep industry expertise to solve complex client challenges and deliver measurable business outcomes.
Practice Development
  • Contribute to the growth and evolution of West Monroe's Healthcare Practice through knowledge sharing, thought leadership, and solution development.
  • Develop Payment Integrity methodologies, tools, and best practices that enhance client delivery.
  • Support recruiting, onboarding, and mentoring efforts across the practice.
  • Actively participate in performance management and career development of team members.
  • Foster a culture of collaboration, inclusion, innovation, and continuous improvement.
  • Contribute to thought leadership through industry participation, conference speaking opportunities, and market-facing content.

Qualifications
  • Bachelor's degree required; advanced degree preferred.
  • 10+ years of consulting, healthcare payer, or healthcare operations experience with significant exposure to Payment Integrity, claims operations, reimbursement, and recovery programs.
  • Demonstrated experience leading complex client engagements and managing executive-level stakeholder relationships.
  • Proven ability to identify, develop, and support new business opportunities within existing and prospective accounts.
  • Strong understanding of healthcare payer operations, claims processing, reimbursement methodologies, provider payment models, and Payment Integrity programs.
  • Experience leading business and technology transformation initiatives within health insurance organizations.
  • Strong program and project management experience, including scope, budget, risk, issue, and stakeholder management.
  • Excellent verbal, written, and executive presentation skills.
  • Demonstrated ability to mentor and develop team members.
  • Commitment to fostering an inclusive culture and embracing diverse perspectives.

Based on pay transparency guidelines, a reasonable expectation for the salary range for this role is listed below. Information on our competitive total rewards package, including our bonus structure and benefits is here. Individual salaries are determined by evaluating a variety of factors including geography, experience, skills, education, and internal equity. Employees in proximity of our Seattle, Washington DC, Los Angeles, New York, and San Francisco offices will have a geographic premium applied to this salary scale.
Employees (and their families) are covered by medical, dental, vision, and basic life insurance. Employees are able to enroll in our company's 401k plan, purchase shares from our employee stock ownership program and be eligible to receive annual bonuses. Employees will also receive unlimited flexible time off and ten paid holidays throughout the calendar year. Eligibility for ten weeks of paid parental leave will also be available upon hire date.
National
$200,000-$250,000 USD
Other consultancies talk at you.
At West Monroe, we work with you.
We're a global business and technology consulting firm passionate about creating measurable value for our clients, delivering real-world solutions.
The combination of business and technology is not new, but how we bring them together is unique. We're fluent in both. We know that technology alone is not the answer, but how we apply it is. We rely on data to constantly adapt and solve new challenges. Actions that work today with outcomes that generate value for years to come.
At West Monroe, we zero in on the heart of the opportunity, getting to results faster and preparing people for what's next.
You'll feel the difference in how we work. We show up personally. We're right there in the room with you, co-creating through the challenges. With West Monroe, collaboration isn't a lofty promise, but a daily action. We work together with you to turn vision into clear action with lasting impact.
West Monroeis an Equal Employment Opportunity Employer
We believe in treating each employee and applicant for employment fairly and with dignity. We base our employment decisions on merit, experience, and potential, without regard to race, color, national origin, sex, sexual orientation, gender identity, marital status, age, religion, disability, veteran status, or any other characteristic prohibited by federal, state or local law. To learn more about diversity, equity and inclusion at West Monroe, visit www.westmonroe.com/inclusion. If you require a reasonable accommodation to participate in our recruiting process, please inquire by sending an email to recruiting@westmonroe.com.
Please review our current policy regarding use of generative artificial intelligence during the application process.
If you are based in California, we encourage you to read West Monroe's Notice at Collection for California residents, provided pursuant to the California Consumer Privacy Act (CCPA) and linked here.

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