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Program Integrity Director Jobs in Reston, VA (NOW HIRING)

InterSystems

Subject Matter Expert

Vienna, VA · On-site

Build trusted relationships with key stakeholders (Medicaid Directors, Program Integrity leads, CIOs, SIU leaders). * Produce high-value assets: * Thought leadership content (whitepapers ...

InterSystems

Subject Matter Expert

Vienna, VA

Build trusted relationships with key stakeholders (Medicaid Directors, Program Integrity leads, CIOs, SIU leaders). * Produce high-value assets: * Thought leadership content (whitepapers ...

KBR

Director of Business Integrity

Arlington, VA

Director of Business Integrity KBR brings together the best and brightest to deliver science ... Manage the company-wide confidential reporting program (hotline, email, and P.O. boxes) * Oversee ...

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Unissant

Program Director

Herndon, VA · On-site

$147K - $213K/yr

Working collaboratively, we advance missions and careers through a focus on honesty, integrity, and ... The Program Director must have at least 10 years of Program Management experience involving large ...

Unissant

Program Director

Washington, DC · On-site

$147K - $213K/yr

Working collaboratively, we advance missions and careers through a focus on honesty, integrity, and ... The Program Director must have at least 10 years of Program Management experience involving large ...

UNISSANT

Program Director

Washington, DC

Working collaboratively, we advance missions and careers through a focus on honesty, integrity, and ... The Program Director must have at least 10 years of Program Management experience involving large ...

American University

Program Director

Washington, DC · On-site

The Program Director is responsible for the strategic design, performance optimization, and ... Maintain the integrity and consistency of WAMU's full-day broadcast sound. 2.) Traffic Log ...

Akima, LLC

Program Manager

Fort Belvoir, VA · On-site

$150K - $250K/yr

... integrity. * Provides financial oversight, including budget planning, cost analysis, and ... direct industry experience * Bachelor's degree in business Analytics, Project Management ...

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Program Integrity Director information

See Reston, VA salary details

$30.7K

$81.4K

$142.5K

How much do program integrity director jobs pay per year?

As of Jul 31, 2026, the average yearly pay for program integrity director in Reston, VA is $81,351.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,100.00 and $96,200.00 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 Reston, VA? For Program Integrity Director jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Program Integrity Director jobs in Reston, VA look for? The top searched job categories for Program Integrity Director jobs in Reston, VA are:
What cities near Reston, VA are hiring for Program Integrity Director jobs? Cities near Reston, VA with the most Program Integrity Director job openings:
Program Integrity Director jobs near you

Program Integrity & Investigations Specialist

CRi

Chantilly, VA • On-site

$50K - $60K/yr

Full-time

Re-posted 5 days ago

Job description

Description
CRi is seeking a Program Integrity & Investigations Specialist to join our team!
Position Summary:
The Program Integrity and Investigations Specialist at CRi is responsible for monitoring program compliance in alignment with federal and state behavioral health provider regulations and industry standards. This role involves conducting thorough investigations into violations of Human Rights to ensure the protection and dignity of individuals served. Additionally, the Specialist performs comprehensive audits across all service programs, identifying areas for improvement and strengthening organizational oversight.
By driving adherence to regulatory requirements and best practices, this position plays a critical role in enhancing service quality, promoting accountability, and supporting continuous improvement within the organization.
Principal Duties and Responsibilities:
Program Compliance Monitoring: Reviews program files (medical, financial, service planning) and conducts environmental inspections to ensure compliance with regulations and the Clinical Policy and Procedure Manual.
Audit and Review: Conducts audits, identifies areas for improvement, and supports corrective action plan development and implementation.
Investigations: Leads internal investigations into compliance issues (e.g., abuse, neglect) and prepares accurate reports.
Quality Improvement and Compliance (QIC) Oversight: Supports internal QIC reviews, prepares quarterly reports, and helps monitor and improve service delivery processes.
Recommendations and Systemic Improvements: Prepares recommendations for program and systemic improvements and evaluates the impact of changes on compliance and performance.
Regulatory Inspections and Reporting: Participates in inspections, contributes to compliance reports, and prepares monthly, quarterly, and annual QIC activity reports.
ICF Manual Maintenance: Maintains and updates the agency's ICF manual to ensure it reflects current regulatory standards.
Operational Support: Assists with audits and creates tools, templates, and guidance documents to improve operational efficiency.
Additional Duties: Performs other duties as needed to support departmental and organizational goals.
Requirements
Other Job Functions:
  • Maintain appropriate level of confidentiality, while practicing the level of transparency valued by the agency.
  • Assist in setting standards for a professional corporate image through quality and friendly service, communication and presentation, by working well with staff at all levels, as well as consumers and external contacts, including individuals of diverse cultures and capabilities.

Minimum Qualifications Required:
  • Bachelor's degree in healthcare administration, business administration, social science, or related field
    • Will consider a combination of education and 5 years of experience in intellectual disabilities program supervision or auditing.
  • Ability to interpret complex regulations, maintain confidentiality, conduct research, make recommendations, and implement solutions. Strong analytical, verbal, written, and presentation skills.
  • Ability to work independently, make sound judgments, and handle competing priorities.
  • Demonstrated knowledge of, or strong interest in, working with individuals with disabilities, preferred.
  • Proficiency in MS Office (Word, Excel, PowerPoint), and experience Electronic Health Record (EHR) usage.
  • Familiarity with CMS, Virginia DBHDS, DSS, and/or CARF; experience with these agencies is strongly preferred.
  • Proven strong organizational skills.

Desired Qualifications:
  • Experience working in the developmental disability and/or mental health field.

Physical Demands:
  • Reliable transportation for travel to program sites in Virginia (Northern VA and Richmond)
  • Standing, sitting, and lifting up to 5-10 lbs.

Working Environment:
  • Programs and other locations throughout CRi's service areas, including Richmond.
  • Office environment.

Supervision Received
Under direct supervision of the Quality Improvement and Compliance Director.
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