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Program Integrity Jobs in Virginia (NOW HIRING)

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Program Integrity information

See Virginia salary details

$24.8K

$51.9K

$89.7K

How much do program integrity jobs pay per year?

As of Jul 8, 2026, the average yearly pay for program integrity in Virginia is $51,911.00, according to ZipRecruiter salary data. Most workers in this role earn between $39,700.00 and $59,000.00 per year, depending on experience, location, and employer.

What are some common challenges faced in a Program Integrity role, and how can they be effectively managed?

Program Integrity professionals often encounter challenges such as ensuring regulatory compliance, detecting and preventing fraud, and navigating complex data systems. Managing these challenges typically involves staying current with evolving policies, collaborating closely with compliance, audit, and legal teams, and leveraging advanced analytics tools to monitor program performance. Effective communication and proactive problem-solving are crucial, as the role often requires balancing the organization's objectives with strict adherence to external regulations.

What is the difference between Program Integrity vs Claims Analyst?

AspectProgram IntegrityClaims Analyst
Required CredentialsTypically requires a bachelor’s degree in healthcare, public health, or related fields; certifications like Certified Professional Coder (CPC) may be beneficialUsually requires a bachelor’s degree in finance, healthcare administration, or related fields; certifications like Certified Claims Professional (CCP) are common
Work EnvironmentGovernment agencies, insurance companies, healthcare organizations focusing on compliance and fraud detectionInsurance companies, healthcare providers, or third-party administrators analyzing claims data
Employer & Industry UsagePrimarily in healthcare, insurance, and government sectors for compliance and fraud preventionIn 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.

What are program integrity jobs?

Program integrity jobs focus on ensuring that government or organizational programs operate effectively, efficiently, and in compliance with laws and regulations. Professionals in these roles are responsible for identifying and preventing fraud, waste, and abuse, often through audits, investigations, and data analysis. They ensure program funds are used as intended, maintain accountability, and help organizations meet regulatory and ethical standards. These positions are commonly found in healthcare, social services, and government agencies.

What are the key skills and qualifications needed to thrive in a Program Integrity role, and why are they important?

To thrive in a Program Integrity role, you need strong analytical skills, attention to detail, and a solid understanding of compliance or regulatory frameworks, usually backed by a relevant degree such as public administration, law, or accounting. Familiarity with data analysis tools, case management systems, and auditing software is often required, along with certifications like Certified Fraud Examiner (CFE) being advantageous. Excellent problem-solving, ethical judgment, and effective communication are vital soft skills for investigating issues and collaborating with stakeholders. These competencies help ensure organizational compliance, prevent fraud, and safeguard resources in regulated environments.

Inpatient Hospice Facility Clinical Manager

Blue Ridge Care

Winchester, VA • On-site

Full-time

Medical, PTO

Posted 22 days ago


Job description

Inpatient Care Center (ICC) Manager – Blue Ridge Care

Your clinical leadership ensures comfort, dignity, and excellence for patients and families during the most critical moments of care.

Your guidance and expertise shape high‑quality inpatient hospice services while supporting clinical teams and strengthening continuity of care across settings.

At Blue Ridge Care, we deliver extraordinary care to improve life’s journey. As a mission‑driven, not‑for‑profit healthcare system, we provide integrated services in hospice, serious illness care, the Program of All‑Inclusive Care for the Elderly (PACE), community thrift shops, and grief support—meeting patients and families with compassion, expertise, and respect.

With a strategic focus on growth, innovation, and clinical excellence, our team of Future Makers is committed to Caring for life by providing individualized, high‑quality end‑of‑life care across our community.

About the Role

The Inpatient Care Center (ICC) Manager provides leadership, mentoring, and clinical oversight for Blue Ridge Care’s Inpatient Care Center. This role ensures that patients’ clinical needs are met through comprehensive assessments and individualized Plans of Care, while maintaining regulatory compliance and program integrity.

The ICC Manager is responsible for supervising all clinical aspects of inpatient care, supporting organizational and departmental goals, managing patient flow and admissions, and fostering a collaborative, ethical, and patient‑centered environment.

How You’ll Make a DifferenceClinical Leadership & Patient Care
  • Act as a patient advocate while ensuring high‑quality, compassionate inpatient hospice care.

  • Plan, evaluate, and document care effectiveness in collaboration with the interdisciplinary team (IDT), including patients, families, physicians, and faculty staff.

  • Provide continuity of care across settings through effective verbal and written communication.

  • Perform admissions to the Inpatient Care Center as needed, including emergent situations.

  • Provide direct patient care during periods of high acuity or limited resources, including assessments, triage, and coverage during staff absences.

  • Serve as a clinical mentor and resource for ICC staff related to documentation, education, and problem solving.

Operations, Admissions & Capacity Management
  • Ensure appropriate and timely admission of patients to the Inpatient Care Center, maintaining optimal unit capacity including weekends.

  • In collaboration with the Medical Director, determine eligibility for admission, appropriate levels of care, and manage the waitlist.

  • Collaborate with field teams, hospital liaisons, and medical providers to transition appropriate patients into the ICC.

  • Participate in hospital rounds and evaluate patients for General Inpatient (GIP) status as requested.

  • Coordinate with external vendors including pharmacy, medical supplies, linens, housekeeping, and dietary services.

Compliance, Quality & Program Integrity
  • Ensure all nursing services and documentation meet regulatory requirements, federal hospice guidelines, Joint Commission standards, and organizational policies.

  • Participate in infection control education, monitoring, and activities.

  • Deliver care in a cost‑effective manner, demonstrating understanding of hospice reimbursement methodologies and payer requirements.

  • Monitor productivity, staff overtime, patient care expenditures, and approve related billing and documentation.

  • Serve as a liaison with vendors, physicians, community‑based facilities, and contracted service partners.

Leadership, Supervision & Communication
  • Provide supervision and conduct performance evaluations for RNs, LPNs, and CNAs, with required documentation.

  • Lead ICC Collaborative Meetings and conduct staff meetings monthly and as needed.

  • Communicate regularly and effectively with clinical staff regarding organizational updates, practice expectations, and operational changes.

  • Support clinical staff leadership needs in the absence of other clinical managers as requested.

  • Model the Blue Ridge Care mission, philosophy, ethical behavior, integrity, and commitment to excellence.

What You BringRequired
  • Current, unrestricted Registered Nurse (RN) license in Virginia.

  • CPR Certification.

  • Valid driver’s license with an insured, reliable vehicle; willingness to travel throughout the service area.

  • Proficiency with electronic medical records and computer systems.

  • Excellent verbal and written communication skills.

  • Strong leadership ability with proven team‑building skills.

Preferred
  • Three (3) or more years of nursing management experience.

  • Two (2) or more years of hospice experience.

  • Bachelor’s degree in Nursing.

  • Certification in Hospice and Palliative Care Nursing (CHPN).

  • Demonstrated experience with regulatory compliance and inpatient hospice operations.

Physical, Sensory & Cognitive Requirements
  • Ability to stand and walk continuously; frequently bend, squat, climb stairs, kneel, lift, and assist patients.

  • Ability to lift up to 25 pounds.

  • Visual acuity sufficient to assess patient condition and read clinical instruments.

  • Hearing acuity sufficient to auscultate blood pressure, hear alarms, and communicate effectively.

  • Ability to concentrate on moderate detail for extended periods with frequent interruptions.

  • Ability to manage stress, emotional situations, interruptions, and multiple priorities while maintaining a professional, compassionate demeanor.

Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.

Why You’ll Love Working Here

At Blue Ridge Care, caring for others begins with caring for our team. As a clinical leader, you’ll have the opportunity to influence care quality, mentor future leaders, and support patients and families at the most meaningful moments of life.

We offer:

  • Competitive Pay

  • PTO & Paid Volunteer Time

  • Comprehensive Health Benefits

  • Tuition Reimbursement & Scholarships

  • Leadership Development & Peer Support

  • 30% Thrift Shop Discount

  • Career Growth aligned with our Blue Ridge Care 2030 Strategic Plan

Your leadership ensures dignity, comfort, and excellence in inpatient hospice care—every day.

Blue Ridge Care is a non‑profit, equal opportunity employer. We celebrate diversity and foster an inclusive environment for all.