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Program Integrity Director Jobs in Santa Fe, NM (NOW HIRING)

Pegasus Senior Living

Memory Care Director

Santa Fe, NM · On-site

... Program provides financial support to employees with health-related needs! (FT/PT) Our Mission: We Celebrate and Enhance All Lives with Kindness & Integrity Highlights of the Memory Care Director ...

New

Home Depot

Store Support

Santa Fe, NM · On-site

$14.75 - $18.50/hr

Direct customer or vendor interaction is sometimes required for these positions. Whether directing ... They must demonstrate a high level of integrity at all times, respond to operational concerns of ...

Home Depot

Store Support

Santa Fe, NM · On-site

$14.75 - $18.50/hr

Direct customer or vendor interaction is sometimes required for these positions. Whether directing ... They must demonstrate a high level of integrity at all times, respond to operational concerns of ...

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All JobsProgram Integrity JobsProgram Integrity Director JobsProgram Integrity Director Jobs in Santa Fe, NM

Program Integrity Director information

See Santa Fe, NM salary details

$29K

$76.8K

$134.5K

How much do program integrity director jobs pay per year?

As of Aug 13, 2026, the average yearly pay for program integrity director in Santa Fe, NM is $76,759.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,000.00 and $90,800.00 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 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 job categories do people searching Program Integrity Director jobs in Santa Fe, NM look for? The top searched job categories for Program Integrity Director jobs in Santa Fe, NM are:
What cities near Santa Fe, NM are hiring for Program Integrity Director jobs? Cities near Santa Fe, NM with the most Program Integrity Director job openings:
Program Integrity Director jobs near you
Infographic showing various Program Integrity Director job openings in Santa Fe, NM as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, 1% Temporary, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $76,759 per year, or $36.9 per hour.

Program Design & Development Consultant - 26-10170

Compu-Vision - IT

Espanola, NM • On-site

Full-time

Posted 2 days ago

New

Job description

Program Design & Development Consultant

Duration: 12+ Months
Location: Santa Fe, New Mexico

Position Overview

We are seeking an experienced Program Design & Development Consultant to support healthcare transformation initiatives, public health programs, and human services modernization efforts. This consultant will serve as a trusted advisor to executive leadership by designing innovative healthcare programs, improving operational performance, ensuring regulatory compliance, and developing long-term strategies that improve health outcomes.

The ideal candidate will have extensive experience working with state Medicaid agencies, healthcare organizations, public health entities, or consulting firms supporting government healthcare initiatives. This individual will lead cross-functional engagements involving policy development, operational assessments, program implementation, performance improvement, quality assurance, and stakeholder collaboration.

This role requires a strategic thinker who can bridge healthcare operations, regulatory requirements, clinical programs, data analytics, and organizational change while working with executive leadership and multiple stakeholders.

Position Summary

The Program Design & Development Consultant will provide expert consulting services supporting healthcare transformation initiatives through strategic planning, program design, operational assessments, quality improvement, policy interpretation, and implementation of innovative healthcare solutions.

The consultant will evaluate current business operations, identify opportunities for improvement, recommend evidence-based solutions, facilitate stakeholder engagement, and oversee the successful implementation of complex healthcare initiatives.

Primary ResponsibilitiesProgram Design & Development
  • Design healthcare and human services programs from concept through implementation.
  • Develop strategic program frameworks aligned with organizational goals.
  • Create implementation roadmaps, governance structures, and operational models.
  • Develop business cases supporting new healthcare initiatives.
  • Recommend innovative service delivery models.
  • Build sustainable operating models supporting long-term program success.
  • Develop measurable performance metrics and success criteria.
Strategic Planning
  • Facilitate executive strategic planning sessions.
  • Conduct organizational readiness assessments.
  • Develop multi-year healthcare transformation roadmaps.
  • Evaluate organizational capabilities and identify operational gaps.
  • Recommend process and performance improvements.
  • Align healthcare initiatives with federal and state priorities.
  • Support executive decision-making through research and analysis.
Healthcare Program Modernization

Support initiatives involving:

  • Medicaid modernization
  • Managed Care programs
  • Public Health initiatives
  • Behavioral Health
  • Maternal & Child Health
  • Public Assistance Programs
  • Healthcare Quality initiatives
  • Human Services transformation
  • Workforce Development
  • Program Integrity initiatives
Regulatory & Policy Consulting
  • Interpret and apply federal and state healthcare regulations.
  • Analyze Medicaid policy and public benefit program requirements.
  • Support healthcare compliance and program governance.
  • Develop policy recommendations.
  • Create Standard Operating Procedures (SOPs).
  • Develop governance documentation.
  • Create regulatory implementation plans and compliance frameworks.
Program Assessment

Develop recommendations supported by quantitative and qualitative analysis and lead evaluations including:

  • Operational assessments
  • Organizational assessments
  • Financial assessments
  • Performance reviews
  • Compliance reviews
  • Process improvement analyses
  • Root cause investigations
  • Risk assessments
Performance Improvement

Develop initiatives focused on:

  • Healthcare quality improvement
  • Operational efficiency
  • Program effectiveness
  • Cost optimization
  • Resource utilization
  • Client experience
  • Workforce effectiveness
  • Continuous improvement methodologies
Stakeholder Engagement

Partner with:

  • Executive Leadership
  • Agency Directors
  • Clinical Leadership
  • Healthcare Providers
  • Community Organizations
  • Advisory Committees
  • Federal Agencies
  • State Agencies
  • Public Health Officials

Lead:

  • Executive presentations
  • Strategic workshops
  • Steering Committees
  • Public meetings
  • Advisory Boards
  • Requirements gathering sessions
Training & Knowledge Transfer

Develop:

  • Operational documentation
  • Training materials
  • Knowledge transfer plans
  • Organizational change strategies
  • User guides
  • Executive briefings

Provide coaching and education to leadership and operational staff.

Required Technical Skills

Candidates should demonstrate experience with:

  • Healthcare Program Design
  • Strategic Planning
  • Organizational Development
  • Healthcare Operations
  • Business Process Improvement
  • Lean Process Improvement
  • Quality Assurance
  • Performance Measurement
  • Program Governance
  • Healthcare Analytics
  • Root Cause Analysis
  • Risk Management
  • Business Case Development
  • Executive Reporting
  • Project Portfolio Management
  • Change Management
  • Stakeholder Management
Healthcare Domain Expertise

Strong experience in one or more of the following areas:

  • Medicaid Programs
  • Managed Care
  • Medicare
  • Public Health
  • Human Services
  • Behavioral Health
  • Maternal & Child Health
  • Healthcare Policy
  • Program Integrity
  • Healthcare Quality
  • Population Health
  • Healthcare Finance
  • Public Assistance Programs
  • Community Health
Mandatory Qualifications
  • Bachelor's degree in Healthcare Administration, Public Health, Business Administration, Public Policy, Nursing, Social Work, Health Informatics, or a related discipline.
  • 10+ years of healthcare consulting or public-sector healthcare experience.
  • Experience supporting state or federal healthcare agencies.
  • Demonstrated success leading healthcare transformation initiatives.
  • Experience designing and implementing complex healthcare programs.
  • Strong understanding of healthcare regulations and policy.
  • Experience facilitating executive-level meetings and presentations.
  • Ability to manage multiple concurrent consulting engagements.
Preferred Qualifications
  • Master's degree such as MPH, MHA, MBA, or MPA.
  • PMP Certification.
  • Lean Six Sigma Green Belt or Black Belt.
  • Certified Professional in Healthcare Quality (CPHQ).
  • Certified Change Management Professional.
  • Medicaid consulting experience.
  • Healthcare strategy consulting experience.
  • Experience supporting Health and Human Services organizations.
Soft Skills

The ideal consultant will possess:

  • Executive presence
  • Exceptional communication skills
  • Strategic thinking
  • Systems thinking
  • Political awareness
  • Relationship building
  • Facilitation expertise
  • Conflict resolution
  • Consensus building
  • Analytical problem solving
  • Critical thinking
  • Adaptability
  • Professional writing
  • Public speaking
Preferred Experience

Candidates with experience supporting the following types of organizations are highly desirable:

  • State Medicaid Agencies
  • Centers for Medicare & Medicaid Services (CMS)
  • Health and Human Services Agencies
  • Public Health Departments
  • Managed Care Organizations
  • Healthcare Consulting Firms
  • Integrated Delivery Networks
  • Academic Medical Centers
  • Government Healthcare Programs
  • Population Health Organizations