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Program Integrity Jobs in Wisconsin (NOW HIRING)

ThedaCare

Retail Pharmacy Technician

Appleton, WI · On-site

... program integrity, financial viability, and optimal patient outcomes. KEY ACCOUNTABILITIES: * Responsible for processing prescriptions throughout the lifecycle including but not limited to order ...

ThedaCare

Retail Pharmacist

Neenah, WI · On-site

... program integrity, financial viability, and optimal patient outcomes. Acts as an authority and advocate of change management redefining the practice of retail pharmacy congruent with the following ...

ULINE

Director of Benefits

Pleasant Prairie, WI · On-site

Ensure compliance with regulations while supporting reporting, audits and program integrity. Minimum Requirements * Bachelor's degree in human resources, business or a related field. * 12+ years of ...

ULINE

Director of Benefits

Kenosha, WI · On-site

Ensure compliance with regulations while supporting reporting, audits and program integrity. Minimum Requirements * Bachelor's degree in human resources, business or a related field. * 12+ years of ...

ULINE

Director of Benefits

Pleasant Prairie, WI · On-site

Ensure compliance with regulations while supporting reporting, audits and program integrity. Minimum Requirements * Bachelor's degree in human resources, business or a related field. * 12+ years of ...

ULINE

Director of Benefits

Milwaukee, WI · On-site

Ensure compliance with regulations while supporting reporting, audits and program integrity. Minimum Requirements * Bachelor's degree in human resources, business or a related field. * 12+ years of ...

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All JobsProgram Integrity JobsProgram Integrity Jobs in Wisconsin

Program Integrity information

See Wisconsin salary details

$25.2K

$52.9K

$91.3K

How much do program integrity jobs pay per year?

As of Jul 8, 2026, the average yearly pay for program integrity in Wisconsin is $52,850.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,400.00 and $60,100.00 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.
What are the most commonly searched types of Program Integrity jobs in Wisconsin? The most popular types of Program Integrity jobs in Wisconsin are:
What cities in Wisconsin are hiring for Program Integrity jobs? Cities in Wisconsin with the most Program Integrity job openings:
Program Integrity jobs near you
Infographic showing various Program Integrity job openings in Wisconsin as of July 2026, with employment types broken down into 81% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $52,850 per year, or $25.4 per hour.
Site Inspector - Remote Wisconsin

Site Inspector - Remote Wisconsin

Gainwell Technologies LLC

Milwaukee, WI • On-site

$54K - $77K/yr

Other

Medical, Life, Retirement, PTO

Posted 27 days ago

Gainwell Technologies rating

7.7

Company rating: 7.7 out of 10

Based on 72 frontline employees who took The Breakroom Quiz

115th of 204 rated software companies

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
The Site Inspector is responsible for conducting provider site visits and program integrity reviews in support of Wisconsin Medicaid provider enrollment and revalidation requirements. This role works closely with the Wisconsin Department of Health Services (DHS) Office of Inspector General (OIG) to verify provider operational readiness, validate compliance with CMS requirements, and support efforts to prevent fraud, waste, and abuse within the Medicaid program. Responsibilities include scheduling and conducting site inspections, documenting findings, performing research, and preparing legally defensible documentation related to enrollment actions and compliance reviews.
Your role in our mission
  • Conduct onsite provider inspections to verify operational status, physical location, business signage, and the provider's ability to perform services identified within enrollment applications.
  • Coordinate and schedule site visits with providers, including communication, appointment management, and utilization of virtual meeting technology when appropriate.
  • Capture photographs, complete inspection templates, document findings, and upload supporting documentation into designated systems in accordance with established procedures.
  • Perform enrollment program integrity compliance reviews, including research, analysis, and evaluation of provider information to identify potential compliance concerns.
  • Prepare detailed reports, recommendations, and supporting documentation for enrollment determinations, sanctions, terminations, denials, and administrative review processes.

What we're looking for
  • Two or more years of experience in inspections, auditing, investigations, compliance, healthcare operations, provider relations, program integrity, fraud prevention, or a related field.
  • Experience conducting research, reviewing documentation, gathering information, and preparing detailed written reports while maintaining accuracy and confidentiality.
  • Strong analytical, organizational, problem-solving, and communication skills with the ability to work independently and manage multiple priorities.
  • Experience working with Medicaid, Medicare, healthcare providers, provider enrollment, regulatory compliance, program integrity, or government-sponsored healthcare programs preferred.
  • Proficiency with Microsoft Office applications, documentation systems, databases, virtual meeting platforms, and technology used to support field-based work.

What you should expect in this role
  • Field-based position requiring frequent travel throughout Wisconsin to conduct provider site visits and inspections.
  • Direct interaction with healthcare providers, clinics, agencies, suppliers, and other Medicaid-enrolled organizations.
  • Collaboration with Wisconsin DHS Office of Inspector General (OIG) and Gainwell program integrity and provider enrollment teams.
  • Independent work environment requiring strong time management, scheduling, documentation, and case management skills.
  • Opportunity to make a direct impact on Medicaid program integrity while supporting compliance initiatives that help prevent fraud, waste, and abuse within the healthcare system.

Pipeline Notice: This is a pipeline requisition. Gainwell will be screening and interviewing qualified candidates on an ongoing basis in anticipation of future hiring needs through the month of August.
Candidates who meet the qualifications may be contacted by a member of our Talent Acquisition team to discuss current and future opportunities.
#LI-REMOTE
#LI-JT1
The pay range for this position is $54,300 - $77,500 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

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Benefits

Hours and flexibility

Workplace

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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