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Program Integrity Director Jobs in Rio Rancho, NM

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Program Integrity Director information

See Rio Rancho, NM salary details

$27.7K

$73.6K

$128.9K

How much do program integrity director jobs pay per year?

As of May 30, 2026, the average yearly pay for program integrity director in Rio Rancho, NM is $73,551.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,900.00 and $87,000.00 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 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 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 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 job categories do people searching Program Integrity Director jobs in Rio Rancho, NM look for? The top searched job categories for Program Integrity Director jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Program Integrity Director jobs? Cities near Rio Rancho, NM with the most Program Integrity Director job openings:
Program Integrity Director jobs near you
Program Integrity Manager (HCA/MAD #10118528)

Program Integrity Manager (HCA/MAD #10118528)

State of New Mexico

Albuquerque, NM • On-site

$29.23 - $43.85/hr

Full-time

Posted 10 days ago

State Of New Mexico rating

7.0

Company rating: 7.0 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

40th of 50 rated states

Job description

$29.23 - $43.85 Hourly
$60,800 - $91,200 Annually
This position is a Pay Band C8
Posting Details
Interviews are anticipated to be conducted within two weeks of closing date.
This job posting may be used to fill multiple vacancies.
Our Vision
  • Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission
  • We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals
  • Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
  • Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
  • Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
  • Build the best team in state government by supporting employees continuous growth and wellness.

Why does the job exist?
The Program Integrity Manager will:
  • Monitor compliance with Code of Federal Regulations, New Mexico Administrative Code and other Medicaid related regulations;
  • Coordinate reporting to oversight agencies such as Centers for Medicare & Medicaid Services (CMS), Office of Inspector General (OIG), U.S. Department of Health and Human Services (HHS), U.S. Governmental Accountability Office (GAO);
  • Coordinate audits and monitor activities;
  • Maintain documentation of audits, training and compliance activities;
  • Draft, review and update compliance plans, policies and procedures.

How does it get done?
The Program Integrity Manager is responsible for:
  • Managing the day-to-day coordination of Program Integrity activities associated with H.R. 1 implementation;
  • Developing and managing dashboards for scheduled and ad hoc audits, surveys and reports;
  • Coordinating the completion, executive review and submission of response documents to federal and state oversight entities;
  • Developing and tracking Program Integrity procedures;
  • Identifying Program Integrity risks and supporting implementation of mitigation strategies to protect Medicaid resources.

Who are the customers?
  • Internal stakeholders across Health Care Authority (HCA) and Medical Assistance Division (MAD), including program integrity staff, eligibility and payments teams, policy and systems partners, and leadership involved in oversight activities.

Ideal Candidate
The Ideal Candidate has experience:
  • Managing program integrity, compliance, or oversight activities within Medicaid or public-sector programs;
  • Coordinating integrity-related work across eligibility, payments, and policy teams;
  • Supporting development and implementation of integrity procedures and controls;
  • Tracking performance indicators and compliance outcomes;
  • Preparing reports and documentation for oversight and leadership review;
  • Identifying and supporting resolution of integrity risks or issues
  • Working within regulated or compliance-driven environments
  • Managing multiple priorities in support of complex program initiatives.

Minimum Qualification
Bachelor's Degree in a relevant field of study from an accredited college or university and two (2) years of professional level experience with a tactical impact directly related to the purpose of the position defined by the agency at the time of recruitment. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling six (6) years may substitute for the required education and experience.
Employment Requirements
Must possess and maintain a valid driver's license.
Must obtain a Defensive driving certification.
Working Conditions
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT), extensive personal computer and phone usage with extended periods of sitting.
Supplemental Information
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Agency Contact Information: Jolene Jaffa, (505) 690-9920. Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.

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