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 ...
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 ...
Program Integrity & Investigations Specialist
Chantilly, VA · On-site
$50K - $60K/yr
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 ...
Program Integrity & Investigations Specialist
Chantilly, VA · On-site
$50K - $60K/yr
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 ...
Provider Payment Integrity Coordinator
Richmond, VA · On-site
$78K - $95K/yr
The position seeks to improve the provider payment experience and ensure program integrity by investigating potential payment errors, identifying root causes of payment issues, coordinating ...
Provider Payment Integrity Coordinator
Richmond, VA · On-site
$78K - $95K/yr
The position seeks to improve the provider payment experience and ensure program integrity by investigating potential payment errors, identifying root causes of payment issues, coordinating ...
Provider Payment Integrity Coordinator
Richmond, VA · On-site +1
$78K - $95K/yr
The position seeks to improve the provider payment experience and ensure program integrity by investigating potential payment errors, identifying root causes of payment issues, coordinating ...
Provider Payment Integrity Coordinator
Richmond, VA · On-site +1
$78K - $95K/yr
The position seeks to improve the provider payment experience and ensure program integrity by investigating potential payment errors, identifying root causes of payment issues, coordinating ...
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
Program Coach
Richmond, VA · On-site
$52K - $59K/yr
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
Program Coach
Richmond, VA · On-site
$52K - $59K/yr
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
This role fosters strong relationships with sites, members, and internal teams to maintain program integrity, ensure compliance with AmeriCorps regulations, and achieve positive program results.
Subject Matter Expert
Vienna, VA · On-site
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Subject Matter Expert
Vienna, VA · On-site
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Subject Matter Expert
Vienna, VA · On-site
$100 - $130/hr
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Subject Matter Expert
Vienna, VA · On-site
$100 - $130/hr
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Subject Matter Expert
Vienna, VA · On-site
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Subject Matter Expert
Vienna, VA · On-site
InterSystems' mission is to help agencies reduce improper payments, improve program integrity, and increase trust in public healthcare systems. We believe we can do this by enabling measurable impact ...
Program Manager
Fort Belvoir, VA · On-site
$150K - $250K/yr
Implements quality assurance processes and change management strategies to maintain program integrity. * Provides financial oversight, including budget planning, cost analysis, and forecasting.
Program Manager
Fort Belvoir, VA · On-site
$150K - $250K/yr
Implements quality assurance processes and change management strategies to maintain program integrity. * Provides financial oversight, including budget planning, cost analysis, and forecasting.
Physical Therapist - Front Royal Family Practice
Front Royal, VA · On-site
$80K - $95K/yr
Physical Therapist - Front Royal Family Practice Front Royal, VA Sign On Bonus/Relocation Assistance and Student Loan Repayment Program! Integrity Rehab Group is an industry leading therapy ...
Physical Therapist - Front Royal Family Practice
Front Royal, VA · On-site
$80K - $95K/yr
Physical Therapist - Front Royal Family Practice Front Royal, VA Sign On Bonus/Relocation Assistance and Student Loan Repayment Program! Integrity Rehab Group is an industry leading therapy ...
This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and state system ...
This role is ideal for someone with deep eligibility experience who enjoys problem-solving, coaching others, and ensuring program integrity. Please: only apply if you have SNAP and state system ...
Translate fraud detection, investigative, oversight, and program integrity objectives into user stories, acceptance criteria, business requirements, and technical artifacts. * Support development and ...
Translate fraud detection, investigative, oversight, and program integrity objectives into user stories, acceptance criteria, business requirements, and technical artifacts. * Support development and ...
Physical Therapist - Front Royal Family Practice
Front Royal, VA · On-site
$80K - $95K/yr
**Sign On Bonus/Relocation Assistance and Student Loan Repayment Program!** Integrity Rehab Group is an industry leading therapy management company that partners with physician practices across the ...
Physical Therapist - Front Royal Family Practice
Front Royal, VA · On-site
$80K - $95K/yr
**Sign On Bonus/Relocation Assistance and Student Loan Repayment Program!** Integrity Rehab Group is an industry leading therapy management company that partners with physician practices across the ...
Program Manager, RSSEP
Alexandria, VA · Hybrid
... integrity and fidelity to RSSEP service models, including suitable-employment standards and equal service delivery to all clients regardless of gender. • Track and report program outcomes and KPIs ...
Posted today
Program Manager, RSSEP
Alexandria, VA · Hybrid
... integrity and fidelity to RSSEP service models, including suitable-employment standards and equal service delivery to all clients regardless of gender. • Track and report program outcomes and KPIs ...
Posted today
Program Integrity information
See Virginia salary details
$24.8K - $30.7K
4% of jobs
$30.7K - $36.6K
12% of jobs
$39K is the 25th percentile. Wages below this are outliers.
$36.6K - $42.5K
22% of jobs
The median wage is $45.9K / yr.
$42.5K - $48.4K
20% of jobs
$48.4K - $54.3K
13% of jobs
$56.6K is the 75th percentile. Wages above this are outliers.
$54.3K - $60.2K
10% of jobs
$60.2K - $66.1K
6% of jobs
$66.1K - $72K
5% of jobs
$72K - $77.9K
3% of jobs
$77.9K - $83.8K
2% of jobs
$83.8K - $89.7K
2% of jobs
$24.8K
$51.9K
$89.7K
How much do program integrity jobs pay per year?
What is a program integrity job?
What are some common challenges faced in a program integrity role, and how can they be effectively managed?
What are the key skills and qualifications needed to thrive in a program integrity role, and why are they important?
What is the difference between Program Integrity vs Claims Analyst?
| Aspect | Program Integrity | Claims Analyst |
|---|---|---|
| Required Credentials | Typically requires a bachelor’s degree in healthcare, public health, or related fields; certifications like Certified Professional Coder (CPC) may be beneficial | Usually requires a bachelor’s degree in finance, healthcare administration, or related fields; certifications like Certified Claims Professional (CCP) are common |
| Work Environment | Government agencies, insurance companies, healthcare organizations focusing on compliance and fraud detection | Insurance companies, healthcare providers, or third-party administrators analyzing claims data |
| Employer & Industry Usage | Primarily in healthcare, insurance, and government sectors for compliance and fraud prevention | In insurance and healthcare sectors for processing and analyzing claims |
Program Integrity professionals focus on preventing fraud, waste, and abuse in healthcare programs, ensuring compliance with regulations. Claims Analysts primarily review and process insurance claims, verifying accuracy and eligibility. While both roles work within healthcare and insurance industries, Program Integrity emphasizes compliance and fraud detection, whereas Claims Analysts concentrate on claims processing and data analysis.

Program Integrity & Investigations Specialist
Chantilly, VA • On-site
Full-time
Re-posted 23 days ago
Job description
CRi is seeking a Program Integrity & Investigations Specialistto 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.