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Program Integrity Director Jobs in Madison, WI (NOW HIRING)

Function independently, and have flexibility, personal integrity, and the ability to work ... Oversee the employee health program in cooperation with the Medical Director and Staff Development ...

Assure regular communication of issues or program with Client * Handle any escalated security ... Staff Management, Financial Management, Integrity, Problem Solving, Conflict Management, Time ...

Assure regular communication of issues or program with Client * Handle any escalated security ... Staff Management, Financial Management, Integrity, Problem Solving, Conflict Management, Time ...

Assure regular communication of issues or program with Client * Handle any escalated security ... Staff Management, Financial Management, Integrity, Problem Solving, Conflict Management, Time ...

Assure regular communication of issues or program with Client * Handle any escalated security ... Staff Management, Financial Management, Integrity, Problem Solving, Conflict Management, Time ...

Position Overview The Sr Director, Revenue Cycle is responsible for the strategic leadership ... Accountable for enterprise revenue integrity programs, ensuring accurate reimbursement, charge ...

Director, Legal

Oregon, WI ยท On-site +1

Want to work for a global company that values integrity, teamwork, and loyalty? Company Overview ... Oversee insurance programs, claims management, and coverage matters in partnership with Finance and ...

We believe in honesty, integrity, and the importance of moral conduct. We defend the freedom of ... This report also contains information on programs and policies designed to prevent and address ...

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Program Integrity Director information

See Madison, WI salary details

$29.7K

$78.8K

$138K

How much do program integrity director jobs pay per year?

As of Jul 13, 2026, the average yearly pay for program integrity director in Madison, WI is $78,792.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,400.00 and $93,200.00 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 Madison, WI? For Program Integrity Director jobs in Madison, WI, the most frequently searched job titles are:
What job categories do people searching Program Integrity Director jobs in Madison, WI look for? The top searched job categories for Program Integrity Director jobs in Madison, WI are:
What cities near Madison, WI are hiring for Program Integrity Director jobs? Cities near Madison, WI with the most Program Integrity Director job openings:

Director of Nursing

Nursing Home Jobs

Madison, WI โ€ข On-site

Other

Posted yesterday


Job description

General Purpose:

To manage the overall operations of the Nursing Department in accordance with Company policies, standards of nursing practices and governmental regulations so as to maintain excellent care of all residents' needs.

Minimum Qualifications:
  • Registered nurse in good standing with required current state license.
  • Minimum two (2) years experience in geriatrics/long-term care.
  • Working knowledge of long-term care regulations.
  • Restorative care philosophy, excellent professional skills (both assessment and hands-on), and good communication and organizational skills.
  • Significant technical experience and demonstrated leadership/management skills.
  • Relate positively and favorably to residents, families, and government regulators, and to work cooperatively with other employees at all levels.
  • Relate to and work with the ill, disabled, elderly, emotionally upset, and at times hostile people within the facility.
  • Perform the essential job functions of this job, with or without reasonable accommodation.
  • Function independently, and have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies.
  • Basic computer knowledge and ability to learn computer software.
Essential Job Functions

This facility expects their employees to promote an atmosphere of teamwork with other employees and hospitality and comfort for its residents. Therefore, the following list of duties is not all-inclusive:

Administrative Functions
  • Participate in facility surveys (inspections) made by authorized governmental agencies.
  • In the absence of the Administrator and Assistant Administrator (if applicable), assume responsibility of the facility.
  • Oversee the employee health program in cooperation with the Medical Director and Staff Development Coordinator.
  • Monitor the Level of Care Reports, Dietary Consultant Reports, and Pharmacy Consultant Reports and take appropriate actions.
  • Plan, develop, organize, implement, evaluate and direct the nursing services department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
  • Assume administrative authority, responsibility and accountability for all functions, activities, and training of the nursing department.
  • Organize, develop, and direct the administration and resident care of the nursing service department
Meeting Functions
  • Participate in Department Supervisor Meetings, Resident Care Plan Meetings, Budget Committee Meetings, Safety Committee Meetings, Quality Assessment and Assurance Committee Meetings, In-service Education, Family Council and any other meeting as directed by the Administrator.
  • Meet daily with Director of Admissions/Marketing, Business Office Manager, and Administrator regarding admission and placement of proposed residents. Evaluate prospective residents in terms of the nursing service they need and the capability of the facility to supply the needed service.
  • Meet monthly with nursing staff regarding Chart Audit and Physician's orders. Review audit with Medical Records prior to submitting to Administration.
Personnel Functions
  • Interview, orient, train, evaluate and supervise nursing department personnel.
  • Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.
  • Make daily rounds of the nursing department to verify that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.
  • Provide appropriate departmental in-service education programs in compliance with Corporate, State and Federal guidelines.ย 
  • Work closely with Administrator in resolving grievances with nursing staff, family members, and residents.
Nursing Care Functions
  • Perform nursing services and deliver resident care services in compliance with Corporate policies and State and Federal regulations.
  • Inform state of any reportable incidents within appropriate time frames. Complete investigative analysis as required.
  • Monitor medication passes and treatment schedules to verify that medications are being administered as ordered and that treatments are provided as scheduled.
  • Provide direct nursing care, as necessary.
  • Regularly inspect the facility and nursing practices for compliance with federal, state, and local standards and regulations.
  • Study Infection Control Reports, Medication Incident Reports and Resident Incident Reports for corrective action.
  • Keep Administrator informed on a daily basis of nursing department functions, recommending changes in techniques or procedures for a more efficient operation.
  • Review discharge summaries on a timely basis.
Safety and Sanitation
  • Monitor nursing service personnel to verify that they are following established safety regulations in the use of equipment and supplies.
  • Provide that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.
  • Be on call for emergencies that supervisory personnel cannot handle.
  • Assure proper handling and emergency care of residents, personnel, and visitors while on the job or in the building.
  • Assure residents a comfortable, clean, orderly and safe environment.
  • Comply with, support and enforce Company policies involving all safety and infection control procedures to include the proper use of mechanical lifts and gait belts.
Equipment and Supply Functions
  • Monitor stock level of medications, medical supplies, equipment, etc., to verify they are maintained on premises at all times to adequately meet the needs of the resident.
  • Create and implement procedures for department equipment to be operated only by trained, authorized personnel in a safe manner.
  • Develop and implement procedures for nursing supplies to be used in an efficient manner to avoid waste.
  • Work closely with Central Supply to be sure changes are made on a timely basis and that inventory is current and medical-nursing supplies are adequate on the nursing stations.
Care Plan and Assessment Functions, Documentation
  • Verify that medical and nursing care is administered in accordance with the resident's wishes, including the implementation of advance directives.
  • Assist with development of and approve final version of the Interdisciplinary Plan of Care for each resident in coordination with the physician, Medical Director, nursing staff, and outside consultants (i.e., nursing, dietary, pharmacy, therapists, etc.) and in accordance with corporate, state and federal guidelines.
  • Confirm accurate completion of forms/reports for the admission, transfer and/or discharge of each resident including, but not limited to, the nursing portion of the PAE, Initial Nursing Assessment, Minimum Data Set (MDS), Resident Care Plan, and the Annual MDS.
  • Review and verify that documentation procedures for nursing are met according to corporate, state and federal guidelines.
  • Review nurses notes to confirm that they are informative and descriptive of the nursing care being provided, that they reflect the resident's response to the care, and that such care is provided in accordance with the resident's wishes.
  • Review Quality Indicator reports and submit to Vice President of Clinical Services on a monthly basis.
Budget and Planning Functions
  • Assist in preparing and planning the nursing service department's budget and submit to the Administrator for his/her review, recommendations, and/or approval.
  • Recommend to the Administrator the equipment and supply needs of the nursing department.
  • Be conscious of cost and attempt to provide quality staff for the nursing department within budgetary constraints.
Facility Privacy Officer Functions
  • Provides oversight of facility's compliance with HIPPA and state regulations to properly maintain the privacy and security of private health information to include:
  • Maintenance and oversight of medical records to ensure that policies and procedures are followed when disclosures are made.
  • Oversight of facility staff related to proper communications with families and visitors and protection of electronically maintained PHI.
  • Consult with the Corporate Privacy Officer with respect to any breach or as issues arise.