212 program integrity specialist jobs at 150 companies in United States
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Program Integrity Specialist II
Baltimore, Maryland, United States
$27/hr OnsiteFull Time
1+ YOEBachelor's degree in business or social services and 1+ year of low-income housing experience preferred. Requires Maryland driver's license, regulatory analysis, compliance, hearing, and documentation skills.
3mo
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Program Integrity & Investigations Specialist
Chantilly, Virginia, United States
$50k-$60k/yr OnsiteFull Time
5+ YOEFive years of experience in intellectual disabilities program supervision or auditing; bachelor’s in healthcare or related field; strong regulatory interpretation, confidentiality, and MS Office/EHR skills.
MS Office, Electronic Health Record (EHR)
1mo
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Program Integrity Specialist - DC Contract
Indianapolis, Indiana, United States
OnsiteFull Time
Perform audits and investigations of claims to detect fraud, waste, and abuse; strong analytical, investigative, communication, and Microsoft Office skills required.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint
1w
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Senior Payment Integrity Program Development Specialist
Rancho Cucamonga, California, United States
$80k-$106k/yr HybridFull Time
5+ YOERequires 5+ years of relevant experience, a bachelor's degree in business or health administration, SQL and Excel skills, claims analytics expertise, and knowledge of coding, reimbursement, and payment integrity.
SQL, Microsoft Excel, ICD-10, CPT, DRG, NCCI, RBRVS, Medi-Cal, APR-DRG, CMS, OIG, HEDIS, CAHPS, NCQA
2w
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Facility Integrity Specialist
Artesia or Glendale or Albuquerque
HybridFull Time
8+ YOERequires 8+ years of plant, terminal, or above-ground storage tank inspection experience, a bachelor's degree or qualifying certification, integrity program expertise, and proficiency with AutoCAD, Microsoft applications, GIS, and industry codes.
AutoCAD, GIS, Microsoft Excel, Microsoft Access, Microsoft Word, Microsoft Project, Microsoft Visio, PCMS, Information Data Management Systems (IDMS), Non-Destructive Examination, Corrosion Monitoring, Piping and Instrumentation Diagrams (P&IDs)
3d
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Program Integrity Clinical Spc
Phoenix, Arizona, United States
$90k-$100k/yr RemoteFull Time
5+ YOERN or physician assistant with 5+ years varied clinical experience in managed care, 3 years utilization, quality, or case management experience, anti-fraud review experience, U.S. citizenship, and DoD background investigation eligibility.
Current Procedural Terminology, antifraud artificial intelligence software
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Senior Payment Integrity Program Development Specialist
Rancho Cucamonga, California, United States
$80k-$106k/yr HybridFull Time
5+ YOERequires 5+ years of relevant experience, a bachelor's degree in business, health administration, or related field, SQL and Excel skills, claims analytics expertise, and concept logic and vendor management experience.
SQL, Microsoft Excel, ICD-10, CPT, DRG, HEDIS, CAHPS, NCQA, CMS, OIG, NCCI, RBRVS, Medi-Cal, DHCS, CalPERS, 457(b)
2w
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UM Program Integrity Specialist (Full-time Remote, North Carolina Based)
North Carolina or Morrisville or Charlotte or Smithfield or Fayetteville
$70k-$90k/yr RemoteFull Time
5+ YOEBachelor’s degree and 5 years developing or evaluating training programs; requires curriculum design, stakeholder collaboration, facilitation or learning platform support, and training effectiveness evaluation.
Alliance University, Microsoft Office, MCG, NCQA, CPTM, CPTD, APTD, CPHQ, CHC, CCEP, Lean Six Sigma Yellow Belt, Lean Six Sigma Green Belt, PMP, CAPM
3d
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ES Benefit Integrity Specialist / 61014590
South Carolina, United States
$39k-$44k/yr FieldFull Time
High school diploma and relevant program experience, or an associate degree substitution. Requires a valid driver's license, vehicle access, fieldwork availability, and benefit program knowledge.
Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Electronic Benefit Transfer (EBT)
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Payment Integrity Program Development Senior Manager – Clinical & Facility Specialist
United States
$111k-$150k/yr RemoteFull Time
5+ YOEActive RN license, inpatient clinical experience, coding certification, and 5+ years authoring new payment integrity claim edits. Requires Medicare rules, multi-setting billing, logic writing, data analysis, and cross-functional leadership expertise.
Ambulatory Surgical Center (ASC), MS-DRG, APR-DRG, APC/OPPS, CPT, HCPCS, SQL, Optum/CES, Cotiviti, McKesson, large language models (LLMs)
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PROGRAM SPECIALIST
Detroit, Michigan, United States
$99k-$128k/yr OnsiteFull Time
1+ YOEOne year of specialized experience in planning and project management, resource integration, automated information systems, program training, and technical advice; GS-11 equivalent experience required.
P2, Corporate Automated Information System, Network Analysis System, Microsoft USAJOBS
2mo
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Program Control Specialist
Stafford, Virginia, United States
OnsiteFull Time
5+ YOEBachelors (or equivalent experience) and 5+ years supporting DoD acquisition programs using the Adaptive Acquisition Framework; expertise with Integrated Master Schedules and MS Project; Microsoft Office proficiency; experience leading DoD acquisition professionals; active TS/SCI clearance.
Microsoft Project, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft SharePoint, Microsoft Teams
3mo
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Implementation Program Specialist
United States
$85k-$107k/yr RemoteFull Time
2+ YOEBachelor's degree or equivalent experience, 2–3 years project management/implementation experience; familiarity with EMR integrations (HL7), Epic/Cerner/OncoEMR preferred; strong communication and stakeholder-management; HIPAA awareness.
EMR, HL7, Epic, Cerner, OncoEMR
3mo
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Management and Program Specialist 1
Portsmouth, Virginia, United States
OnsiteFull Time
3+ YOEThree years of IT-driven work experience with data development/integration; knowledge of DoD standards; program management and reporting experience.
Microsoft Office
1mo
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Program Controls Specialist IV
Phoenix, Arizona, United States
HybridFull Time
5+ YOE5+ years project/business management experience with cost/schedule integration, EVM analysis, budgeting and forecasting; Microsoft Project and SAP experience; PMP preferred; must be a U.S. Person.
Microsoft Project, SAP, Earned Value Management (EVM)
2w
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Strategic Resource & Program Integration Specialist
Arnold Air Force Base, Tennessee, United States
OnsiteFull Time
Program management or portfolio analysis experience in technical, engineering, or RDT&E settings; project lifecycle and acquisition knowledge; strong analytical, collaboration, communication, and Microsoft Office skills.
Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
3mo
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Senior Program Integration Specialist
Chantilly, Virginia, United States
OnsiteFull Time
10+ YOEBachelor's degree; 10+ years acquisition management; DoD program support; proficiency with Task Management Tool and ETMS; executive staffing packages; knowledge of DoD budgeting; strong communication and analytical skills; ability to work independently and collaboratively.
Task Management Tool (TMT), Enterprise Task Management Software Solutions (ETMS)
2w
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Registered Nurse Clinical Documentation Integrity Specialist - Inpatient
Tucson, Arizona, United States
OnsiteFull Time
3+ YOEQualified nursing program graduate with three years of acute-care RN experience and Arizona RN licensure; strong clinical knowledge, critical thinking, communication, and inpatient documentation review skills required.
medical record, workflow tools
3mo
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Program Planning & Scheduling Specialist
Melbourne, Florida, United States
$25-$40/hr OnsiteFull Time
3+ YOEAbility to obtain a DoD Secret clearance; experience developing Integrated Master Schedules; proficiency in MS Project, Excel, PowerPoint; EVMS knowledge; aerospace/defense experience preferred.
Microsoft Project, Open Plan, Primavera P6, Excel, PowerPoint
1mo
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Senior Specialist, Program Scheduler (40486)
Fort Wayne, Indiana, United States
OnsiteFull Time
4+ YOEDevelop and analyze integrated master schedules, perform schedule and EVMS analysis, support replanning and schedule recovery, and coordinate across functional teams for DoD programs.
Microsoft Project, Structured Solutions Incorporated (SSI), Earned Value Management Systems (EVMS)
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