Program Manager, Payment Integrity

Blue Cross and Blue Shield of Massachusetts Inc.; Boston (MA); On-site; USD 120,000 - 180,000; Full time

Job summary

Blue Cross Blue Shield of Massachusetts is seeking a Senior Program Manager to lead cost-savings initiatives and oversee governance for the Payment Integrity program. You will manage a project manager and data team, coordinating cross-Plan initiatives and liaising with the Blue Cross Blue Shield Association to align national strategies.

The role requires a Bachelor's degree, strong communication, and analytical skills, with experience in healthcare program management.

Qualifications

• 5+ years of program or project management experience in healthcare or related field.
• Experience leading or mentoring team members.
• Proven ability to manage a portfolio of complex programs and deliver outcomes.
• Strong communication and stakeholder management skills.

Responsibilities

• Lead and develop a high-performing team of project managers and analytics resources.
• Oversee a portfolio of high-impact medical cost-savings initiatives and ensure timely milestones and reporting.
• Support governance processes and strategic communication, including minutes, action tracking, and newsletter updates.

Skills

Leadership

Communication

Analytical skills

Project management

Education

Bachelor's Degree

Tools

Microsoft Project

Excel

Job description

Ready to help us transform healthcare? Bring your true colors to blue.

What we need: The BCBSMA Payment Integrity (PI) team is dedicated to safeguarding healthcare claims by identifying and addressing provider billing and coding errors.

We are seeking a Senior Program Manager to lead the execution of key medical cost-savings initiatives and support the implementation of our evolving governance model.

This role will oversee a project manager and supporting data team to drive the successful execution of critical cost-savings and strategic programs.

The Program Manager will manage the oversight and execution of initiatives originating from the Payment Integrity Steering Committee.

In addition, this role will act as a key liaison with the Blue Cross Blue Shield Association, ensuring alignment with national Payment Integrity strategies, sharing best practices, and coordinating cross-Plan initiatives.

Key Responsibilities

• 1. Lead and Develop a High-Performing Team

  Provide strategic leadership, coaching, and mentorship to project managers and analytic resources. Foster accountability, professional growth, and collaboration to ensure successful execution of internal and external payment integrity initiatives.

• 2. Oversee Payment Integrity Programs

  Manage a portfolio of high-impact medical cost savings initiatives. Ensure the development of comprehensive project plans, proactive risk mitigation, milestone tracking, and clear status reporting to the Payment Integrity Steering Committee. Drive timely and measurable program outcomes.

• 3. Support Governance and Strategic Communication

  Manage governance processes for the cross-functional Payment Integrity Steering Committee, including agenda setting, meeting facilitation support, documentation of minutes, and tracking of action items. Oversee creation and distribution of the monthly Payment Integrity newsletter to ensure transparency and stakeholder engagement. Maintain and update the Payment Integrity strategic plan.

We’re Looking for

• Bachelor’s Degree required.
• Excellent verbal and written communication skills, with experience facilitating meetings and presenting to diverse audiences.
• Strong analytical skills and proficiency in working with and analyzing data to track performance and inform decisions.
• Very strong technical aptitude with the ability to use Microsoft products effectively, including project management software.

What You Bring

• Experience in leading or mentoring team members required; direct people management experience preferred.
• Proven ability to manage a portfolio of complex projects, set priorities for a team, and drive initiatives to completion.
• 5+ years of experience in project or program management, preferably within a healthcare payment integrity, finance, or procurement environment.

What You’ll Gain: In this role, you will gain significant visibility into the strategic operations of our Payment Integrity department while developing your leadership skills. You will have the opportunity to lead a team dedicated to high-impact projects that contribute directly to our corporate savings goals. You will play a crucial part in managing the resources and partnerships needed to transform our payment integrity capabilities and ensure we remain at the forefront of the industry.

You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant.

We encourage you to bring us your true colors, , your perspectives, and your experiences.

It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page.

For more information on how we work and support that work/life balance visit our "How We Work" Page.

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation’s best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.