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Program Integrity Director Jobs (NOW HIRING)

State of Illinois

PROGRAM INTEGRITY AUDITOR I

Chicago, IL · Hybrid

$5.5K - $7.8K/mo

PROGRAM INTEGRITY AUDITOR I - 34631 Skill Option: None Bilingual Option: None Salary: Anticipated ... Provides direct support in the development and presentation of detailed, highly sophisticated ...

New

State of Illinois

PROGRAM INTEGRITY AUDITOR I

Chicago, IL · Hybrid

$5.5K - $7.8K/mo

PROGRAM INTEGRITY AUDITOR I - 34631 Skill Option: None Bilingual Option: None Salary: Anticipated ... Provides direct support in the development and presentation of detailed, highly sophisticated ...

New

Bellese

Program Director

$170K - $220K/yr

As a Program Director, you will be responsible for leading delivery teams to shape the strategic ... UCM The Centers for Medicare & Medicaid Services (CMS) is enhancing program integrity efforts to ...

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Program Integrity Director information

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$29.5K

$78.2K

$137K

How much do program integrity director jobs pay per year?

As of Sep 7, 2026, the average yearly pay for program integrity director in the United States is $78,196.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,000.00 and $92,500.00 per year, depending on experience, location, and employer.

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 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.

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Program Integrity Director jobs near you
Infographic showing various Program Integrity Director job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $78,196 per year, or $37.6 per hour.

Deputy Center Director (Medicaid Program Integrity)

Department of Human Services

Windsor Mill, MD

$151K/yr

Full-time

Posted 26 days ago

Job description

This position is located in the Center for Program Integrity (CPI) at the Centers for Medicare and Medicaid Services (CMS).
As the Deputy Center Director (Medicaid Program Integrity), you will provide executive leadership, direction and coordination for the management of a cohesive, agency-wide approach to ensuring program integrity across the Medicaid and Children's Health Insurance Program (CHIP).Qualifications:Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin.
To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position.
There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs).
TECHNICAL QUALIFICATIONS (TQs): Your resume should demonstrate accomplishments that would satisfy the technical qualifications.
TQ 1: Demonstrated executive-level experience leading national program integrity efforts for Medicaid, the Children's Health Insurance Program (CHIP), or similar Federal health care programs. This includes developing and leading strategies to prevent, detect, and address fraud, waste, abuse, and improper payments; overseeing nationwide provider oversight and enforcement activities; coordinating audits, investigations, and corrective actions with Federal and State agencies, State Medicaid Fraud Control Units (MFCUs), and law enforcement partners; and achieving measurable results that improved program integrity, strengthened accountability, or reduced improper payments across the country.
TQ 2: Demonstrated executive-level experience integrating program integrity into enterprise strategy, policy development, and national operational frameworks for Medicaid, the Children's Health Insurance Program (CHIP), or comparable Federal health care programs. This includes identifying gaps in statutory, regulatory, or policy frameworks; developing and implementing policy, regulatory, or operational solutions to address emerging risks and program vulnerabilities; aligning program integrity initiatives with agency-wide strategic planning, budget priorities, and legislative proposals; and advising senior leadership on program integrity strategy, risk management, and national policy direction.
EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position.
There are five ECQs:
  • ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people.
  • ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades.
  • ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality.
  • ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable.
  • ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors.

Note: If you are a member of the SES or have been certified through successful participation in an OPM approved SES Candidate Development Program (SESCDP), or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES.Education:This job does not have an education qualification requirement.Employment Type: OTHER

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