Program Manager, Payment Integrity

Blue Cross Blue Shield of Massachusetts•Boston, MA

About The Position

The BCBSMA Payment Integrity team safeguards healthcare claims by identifying and addressing provider billing and coding errors. The Senior Program Manager leads execution of key medical cost-savings initiatives and supports implementation of the team’s evolving governance model. The role oversees a project manager and supporting data team, manages initiatives originating from the Payment Integrity Steering Committee, and serves as a liaison with the Blue Cross Blue Shield Association to align with national Payment Integrity strategies, share best practices, and coordinate cross-Plan initiatives. The position provides leadership, coaching, and mentorship to project managers and analytic resources; manages a portfolio of high-impact medical cost-savings initiatives; and oversees project planning, risk mitigation, milestone tracking, reporting, governance processes, and strategic communications. The role also maintains the Payment Integrity strategic plan and oversees the monthly Payment Integrity newsletter. The position offers visibility into Payment Integrity’s strategic operations and the opportunity to lead a team working on projects that contribute to corporate savings goals. It is based in Boston or Hingham and is full-time. The stated salary range is $125,460 to $153,340, and the role is also eligible for variable pay.

Requirements

Bachelor’s degree required.
Excellent verbal and written communication skills, including experience facilitating meetings and presenting to diverse audiences.
Strong analytical skills and proficiency working with and analyzing data to track performance and inform decisions.
Very strong technical aptitude and effective use of Microsoft products, including project management software.
Experience leading or mentoring team members required.
Ability to manage a portfolio of complex projects, set priorities for a team, and drive initiatives to completion.
At least 5 years of experience in project or program management.

Nice To Haves

Direct people management experience preferred.
Experience in a healthcare payment integrity, finance, or procurement environment preferred.

Responsibilities

Provide strategic leadership, coaching, and mentorship to project managers and analytic resources.
Foster accountability, professional growth, and collaboration across internal and external Payment Integrity initiatives.
Manage a portfolio of high-impact medical cost-savings initiatives.
Ensure comprehensive project plans, proactive risk mitigation, milestone tracking, and clear status reporting to the Payment Integrity Steering Committee.
Drive timely and measurable program outcomes.
Manage governance processes for the cross-functional Payment Integrity Steering Committee, including agenda setting, meeting facilitation support, minutes, and action-item tracking.
Oversee creation and distribution of the monthly Payment Integrity newsletter.
Maintain and update the Payment Integrity strategic plan.
Manage initiatives originating from the Payment Integrity Steering Committee.
Liaise with the Blue Cross Blue Shield Association to align with national Payment Integrity strategies, share best practices, and coordinate cross-Plan initiatives.