Ready to help us transform healthcare? Bring your true colors to blue. The Role: The Payment Integrity Project Manager will report to the Program Manager, Payment Integrity and will lead the implementation of critical projects focused on improving how Blue Cross ensures that health care claims are paid correctly. Payment Integrity is a key area of focus at Blue Cross and is recognized as an opportunity for innovation with high potential value and cost savings. This is a hands-on role responsible for the end-to-end management of medium-to-high complex projects that are central to our company's strategic objectives. The Senior Project Manager will orchestrate the efforts of cross-functional teams to ensure these high-priority projects are delivered successfully, on schedule, and within budget. The ideal candidate has strong experience in project management methodologies and understands how to navigate complex stakeholder environments to drive results. Key Functions End-to-End Project Management: Take full ownership of highly visible payment integrity projects, from initial planning and scoping through to implementation, launch, and post-launch analysis. Detailed Project Planning: Develop and manage comprehensive project plans, defining project scope, timelines, resource requirements, and budgets for critical initiatives. Cross-Functional Team Leadership: Lead and coordinate the day-to-day activities of project teams, ensuring clear communication and accountability across departments like IT, Claims, Analytics, and Provider Relations. Stakeholder Communication: Serve as the primary point of contact for high-visibility projects, providing clear, concise, and regular status updates and reports to senior leadership and key stakeholders. Risk and Dependency Management: Proactively identify, track, and mitigate project risks, issues, and dependencies to ensure smooth and successful implementation. Implementation and Execution: Drive the execution of project tasks, manage deliverables, and ensure project milestones are met, holding team members and stakeholders accountable. Performance Tracking: Define and track key project metrics and KPIs to measure success and report on the business impact of completed projects to leadership This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties. We’re Looking For: Bachelor's degree in healthcare administration, business, finance, or a related field. 5+ years of direct, hands-on experience in project management, specifically leading complex, large-scale, and highly visible projects. Proven track record of successfully implementing projects within the healthcare payment integrity or claims processing space. Expertise in project management methodologies (e.g., Agile, Waterfall) and proficiency with project management software (e.g., Jira, Smartsheet, MS Project). Exceptional organizational skills and a demonstrated ability to manage multiple priorities in a fast-paced environment. Strong leadership and communication skills, with the ability to influence and motivate cross-functional teams and report effectively to senior management. In-depth understanding of the project lifecycle and the intricacies of implementing business and technology solutions. Preferred Qualifications Experience with process improvement methodologies (e.g., Lean, Six Sigma). Strong analytical and problem-solving skills with a data-driven approach to decision-making. Deep knowledge of medical coding, billing, and reimbursement methodologies. Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above Location Boston, Hingham Time Type Full time Salary Range: $94,410.00 - $115,390.00 The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay. We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. WHY Blue Cross Blue Shield of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. 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. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. 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. Our Commitment to You We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance. 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.

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