Program Manager, Payment Integrity

Blue Cross Blue Shield of Massachusetts•Boston, MA

1d•$125,460 - $153,340

About The Position

Blue Cross Blue Shield of Massachusetts is seeking a Senior Program Manager for its Payment Integrity team, which safeguards healthcare claims by identifying and addressing provider billing and coding errors. The role leads execution of key medical cost-savings initiatives and supports implementation of an evolving governance model. It oversees a project manager and supporting data team, managing initiatives originating from the Payment Integrity Steering Committee. The position also 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 Program Manager provides strategic leadership, coaching, and mentorship to project managers and analytic resources; oversees a portfolio of high-impact medical cost-savings initiatives; and supports governance and strategic communications. Responsibilities include project planning, risk mitigation, milestone tracking, committee meeting support and documentation, newsletter oversight, and maintaining the Payment Integrity strategic plan. The role offers visibility into the strategic operations of the Payment Integrity department and the opportunity to lead a team working on projects tied to corporate savings goals. The position is based in Boston or Hingham and is full time. The listed salary range is $125,460 to $153,340, and the role is eligible for variable pay. Benefits include paid time off, medical, dental, and vision insurance, a 401(k), and well-being benefits for eligible employees.

Requirements

Bachelor’s degree required.
Excellent verbal and written communication skills.
Experience facilitating meetings and presenting to diverse audiences.
Strong analytical skills and proficiency working with and analyzing data to track performance and inform decisions.
Strong technical aptitude and ability to use Microsoft products effectively, including project management software.
Experience leading or mentoring team members.
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 the team.
Manage a portfolio of high-impact medical cost-savings initiatives.
Develop comprehensive project plans, mitigate risks, track milestones, and provide clear status reports 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.
Serve as a liaison with the Blue Cross Blue Shield Association to align with national strategies, share best practices, and coordinate cross-Plan initiatives.