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Program Integrity Jobs in Wisconsin (NOW HIRING)

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STORE/PRICE INTEGRITY LEAD CLERK

Columbus, WI · On-site

$16.75 - $22.75/hr

Emotional and financial support with free counseling through our Employee Assistance Program and ... Past work record reflects dependability and integrity * Knowledge of applicable laws and ...

Pick 'n Save

STORE/PRICE INTEGRITY LEAD CLERK

Milwaukee, WI · On-site

$14.50 - $20/hr

Emotional and financial support with free counseling through our Employee Assistance Program and ... Past work record reflects dependability and integrity * Knowledge of applicable laws and ...

SoloPoint Solutions

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Program Manager

Milwaukee, WI · On-site

$120K - $140K/yr

Experience building strong customer relationships; high emotional intelligence, patience, integrity ... Own customer program execution from order intake through delivery, serving as the primary customer ...

Federal Heath

Program Coordinator

Racine, WI · On-site

We are looking to add a talented and motivated Program Coordinator who shares our values of teamwork, commitment, integrity, and mutual respect to our Racine, WI or Jacksonville, TX team! Position ...

Federal Heath

Program Coordinator

Racine, WI · On-site

$40K - $45K/yr

We are looking to add a talented and motivated Program Coordinator who shares our values of teamwork, commitment, integrity, and mutual respect to our Racine, WI or Jacksonville, TX team! Position ...

VITAS Healthcare

Program Scheduler

Milwaukee, WI · On-site

Enters accurate information to support data integrity in computer applications. * Responds ... Program Many of our positions offer the opportunity to work day or night shifts, weekdays or ...

VITAS Healthcare

Program Scheduler

Milwaukee, WI · On-site

Enters accurate information to support data integrity in computer applications. * Responds ... Program Many of our positions offer the opportunity to work day or night shifts, weekdays or ...

CliftonLarsonAllen

Program Manager

Milwaukee, WI · On-site

Most important, demonstrate a high level of integrity and dependability with a strong sense of ... Develop and manage program plans, including defining scope, objectives, and deliverables. Ensure ...

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Showing results 41-60

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 Sep 13, 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 is a program integrity job?

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 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 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 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 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 August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $52,850 per year, or $25.4 per hour.

Contracting and Revenue Integrity Specialist

Mauston, WI • On-site

Mile Bluff Medical Center
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Mile Bluff Medical Centerexternal

Full-time

Re-posted 21 days ago

Mile Bluff Medical Center rating

6.7

Company rating: 6.7 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

General Information:
Job title: Contracting and Revenue Integrity Specialist
Schedule: 80 hours per pay period; Monday - Friday - 8:00am to 4:30pm
Weekend Requirement: No weekends
Holiday Requirement: Paid holidays
Position Summary:
The Contracting and Revenue Integrity Specialist supports the Chief Financial Officer in managing payer contracting activities, reimbursement analysis, and revenue optimization initiatives for the hospital and affiliated clinics, nursing homes, and retail pharmacies. The position is responsible for maintaining the organization's Charge Description Master (CDM), monitoring reimbursement performance, supporting contract negotiations, and ensuring compliance with applicable billing and regulatory requirements.
This role serves as a key liaison between Administration, Finance, Patient Financial Services, Clinic Operations, Compliance, and Clinical Departments to promote accurate charging, maximize reimbursement, and maintain the financial integrity of Mile Bluff Medical Center services.
Position Responsibilities:
  • Assist the CFO by coordinating negotiation, renewal, and implementation of managed care contracts with commercial insurers, Medicare Advantage plans, Medicaid Managed Care Organizations, and other payers.
  • Review care agreements and analyze reimbursement methodologies, fee schedules, and payment policies.
  • Perform financial analyses to assess the impact of proposed contract terms and reimbursement changes.
  • Maintain payer contract files, renewal schedules, and reimbursement documentation.
  • Develop reimbursement and contract performance reports. Prepare reports and recommendations for CFO regarding contract performance and reimbursement trends.
  • Maintain and update the medical center Charge Description Master (CDM).
  • Coordinate annual and ongoing reviews of charge structures, HCPCS, CPT, revenue codes, and pricing. Ensure compliance with Medicare, Medicaid, commercial payer, and regulatory billing requirements.
  • Collaborate with department leaders to establish charges for new services, procedures, equipment, and supplies. Monitor coding and billing changes impacting charge capture and reimbursement.
  • Identify opportunities to improve charge capture and reimbursement accuracy.
  • Monitor compliance with billing regulations and payer requirements.
  • Analyze reimbursement impacts related to new services and programs.
  • Support regulatory audits and documentation requests.
  • Coordinate enrollment, revalidation, and maintenance activities for hospital and clinic providers with Medicare, Medicaid, commercial payers, and managed care organizations.
  • Add newly hired providers to managed care contracts and payer networks in a timely manner to prevent reimbursement delays.
  • Serve as the organization's primary administrator for Medicare Provider Enrollment, Chain, and Ownership System (PECOS) activities. Maintain hospital, clinic, and provider enrollment records within PECOS.
  • Maintain organizational and provider enrollment records within Wisconsin Forward Health.
  • Coordinate Medicare, Medicaid, and Commercial payer revalidations, ownership updates, provider additions and deletions, practice location changes, and other enrollment actions.
  • Perform other duties as requested.

Position Requirements:
  • Associate degree in Business Administration, Accounting, Healthcare Administration preferred.
  • Minimum three years of experience in healthcare finance, reimbursement, managed care contracting, chargemaster management, revenue integrity, revenue cycle, or related healthcare operations required.
  • Experience with Rural Health Clinics or rural healthcare organizations preferred.

Knowledge, Skills, & Abilities
  • Knowledge of hospital and clinic reimbursement methodologies.
  • Understanding of Medicare, Medicaid, commercial insurance, and managed care contracts.
  • Knowledge of chargemaster maintenance, charge capture, CPT/HCPCS coding, and revenue codes.
  • Strong analytical and financial modeling skills.
  • Advanced proficiency in Microsoft Excel and healthcare financial reporting tools.
  • Ability to interpret contractual language and reimbursement methodologies.
  • Strong organizational, communication, and project management skills.
  • Ability to manage multiple priorities and work independently.

Why Mile Bluff Medical Center?
Mile Bluff Medical Center is a place where people come first. Our team is comprised of caring, patient-centered professionals serving pediatric through geriatric populations in our rural community. Our not-for-profit organization prides itself on providing state-of-the-art healthcare services, a positive work environment, and a team where employees feel valued and supported. Mile Bluff is an independent organization that offers competitive wages, great benefits and the opportunity for growth. Mile Bluff makes decisions for its employees and patients locally without relying on a large health system in another community.

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