Post-Pay Payment Integrity Implementation Lead

Lyric; Richmond (VA); A distancia; USD 125.000 - 188.000; Jornada completa

Descripción de la vacante

Lyric is seeking a Client Engagement Manager (Post-Pay), Specialist to lead payer implementations and translate client needs into clear requirements across the full lifecycle. You will coordinate cross-functional teams and ensure alignment with contracted scope and outcomes.

This role emphasizes expert knowledge of COB, data mining, DRG review, and Lyric Replay, with responsibilities spanning discovery, design, testing, go-live, and ongoing adoption and optimization.

Formación

• Bachelor's degree in healthcare administration, business, information systems, data analytics, project management, or a related field.
• Minimum of seven (7) years of progressive experience in healthcare payment integrity, payer claims operations, healthcare technology implementation, business analysis, or a closely related field.
• Minimum of five (5) years leading complex, client-facing healthcare implementations or workstreams from discovery and requirements through testing, go-live, and post-go-live support.
• Expert-level knowledge of post-payment payment integrity with demonstrated experience across COB, data mining, DRG review, coding or clinical chart review, overpayment recovery, appeals, and reconciliation.
• Demonstrated ability to elicit, analyze, document, validate, and obtain approval for complex business and technical requirements.
• Experience partnering with Business Analysts and technical teams to develop process flows, user stories, acceptance criteria, data specifications, and traceability.
• Strong understanding of healthcare claims and supporting data domains, data mapping, source-to-target logic, data validation, and common integration methods such as secure file transfer and APIs.
• Experience maintaining RAID logs, decision logs, action trackers, change controls, requirements repositories, test evidence, and implementation documentation.
• Ability to explain sophisticated payment integrity workflows and product behavior clearly to business, operational, technical, and executive audiences.
• Excellent facilitation, written communication, presentation, relationship management, negotiation, and issue-resolution skills.
• Ability to travel approximately 20 percent, including client-site travel as needed.

Responsabilidades

• Serve as the primary payment integrity implementation lead and day-to-day point of contact for assigned payer clients.
• Lead discovery sessions, working meetings, demonstrations, status reviews, decision forums, and executive-ready updates.
• Build trusted relationships with client leaders, SMEs, project managers, data and technology teams, and operational users.
• Set clear expectations, confirm ownership and due dates, follow through on commitments, and communicate changes, barriers, and decisions promptly.
• Advise clients on implementation choices, workflow design, and practical tradeoffs while keeping the solution aligned with contracted scope and business outcomes.
• Own the end-to-end requirements lifecycle, documentation, traceability, validation, change control, and formal approval.
• Partner with the Business Analyst to translate client needs into detailed requirements, process flows, user stories, acceptance criteria, data specifications, and configuration decisions.
• Coordinate implementation milestones and dependencies across discovery, design, configuration, integration, testing, training, cutover, go-live, and hypercare.
• Lead or support escalations with structured discovery, solution proposals, and documented resolution paths.
• Remain a knowledgeable client and internal resource after go-live, support adoption, optimization, and expansion opportunities.

Conocimientos

Communication skills

Stakeholder management

Facilitation

Negotiation

Problem solving

Educación

Bachelor's degree in relevant field

Herramientas

Jira

Azure DevOps

Confluence

Microsoft Office Suite

SQL

Descripción del empleo

Lyric is seeking a Client Engagement Manager (Post-Pay), Specialist to lead payer implementations and translate client needs into clear requirements across the full lifecycle. You will coordinate cross-functional teams and ensure alignment with contracted scope and outcomes.

This role emphasizes expert knowledge of COB, data mining, DRG review, and Lyric Replay, with responsibilities spanning discovery, design, testing, go-live, and ongoing adoption and optimization.