Remote - US
Full time
JR967
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments.
Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position.
The Senior Client Engagement Manager (Post-Pay) is the primary client-facing lead responsible for translating payer needs into clear, complete, and implementable requirements across the full implementation lifecycle. This role owns requirements discovery, implementation artifacts, client communications, decision tracking, and cross-functional alignment from initial design through testing, go-live, hypercare, and ongoing support.
The role requires expert-level knowledge of the post-payment payment integrity continuum, including Coordination of Benefits (COB), data mining, DRG and coding or clinical chart review, and Lyric's Replay product suite. The position connects client business objectives with Lyric's product, business analysis, data, engineering, configuration, quality assurance, and operations teams. This person must understand healthcare data domains, source data assets, data mapping, claim and member workflows, and product functionality well enough to ask the right questions, identify gaps, explain how the solution works, and ensure that requirements preserve the client's intent. Thjs person works closely with cross-functional teams - including Implementation, Go-to Market, Product, Engineering, Analytics and others - to configure, deploy, and drive adoption of products in alignment with client roadmaps.
The successful candidate is a trusted advisor and practical sounding board for the client. They bring structure to ambiguity, maintain disciplined governance through requirements, decisions, risks, assumptions, issues, and dependencies, and remain engaged after go-live to support adoption, stabilization, and continuous improvement.
ESSENTIAL JOB RESPONSIBILITIES
Client Partnership and Implementation Leadership
- 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.
Requirements Ownership and Artifact Governance
- Own the end-to-end requirements lifecycle, documentation, traceability, validation, change control, and formal approval.
- Support client and Lyric teams to capture business, operational, product, reporting, data, integration, security, testing, and readiness requirements in clear language that both client and technical teams can use.
- Partner with the Business Analyst to translate client needs into detailed requirements, process flows, user stories, acceptance criteria, data specifications, and configuration decisions.
- Complete an internal quality and feasibility review with the Business Analyst and accountable technical or product owners before requesting client approval.
- Maintain the authoritative set of implementation artifacts, including requirements, workflow documentation, data dictionaries and mappings, decision logs, RAID logs, action trackers, meeting notes, test evidence, approvals, training materials, and transition documentation.
- Control requirement changes by documenting the business need, impact, decision, owner, approval, and downstream effect on scope, timeline, configuration, testing, and operations.
Payment Integrity and Product Expertise
- Serve as an expert resource across the post-payment continuum, including COB, data mining, DRG review, coding or clinical chart review, provider outreach, overpayment validation, recovery, appeals, reconciliation, and reporting.
- Demonstrate strong working knowledge of Lyric Replay products and explain product capabilities, workflows, configuration options, dependencies, limitations, and expected user experience.
- Answer client and internal questions about how the platform and implementation workflows function, and coordinate timely validation when a question requires product or technical confirmation.
- Identify where client policy, reimbursement methodology, operating model, data availability, or contractual requirements may affect solution design and downstream results.
- Ensure implementation decisions support accurate, defensible, scalable, and auditable payment integrity outcomes.
Data Discovery, Mapping, and Validation
- Lead business-oriented discovery of claims, claim-line, member, eligibility, provider, group, benefit, contract, payment, clinical, recovery, and reference data required by the solution.
- Understand data domains, source systems, file layouts, data lineage, key relationships, code sets, field definitions, timing, completeness, and known data limitations.
- Partner with client data teams and Lyric technical teams to document source-to-target mappings, transformation rules, default values, exclusions, reconciliation logic, and data-quality expectations.
- Confirm that data requirements reflect the intended payment integrity workflows and that gaps or assumptions are documented, resolved, and approved.
- Support data profiling, mapping reviews, validation, defect triage, and readiness decisions using business and domain expertise.
Cross-Functional Delivery and Governance
- Act as the communication bridge between the client and Lyric product, Business Analysis, engineering, data, configuration, quality assurance, security, operations, and customer success teams.
- Maintain the RAID log and decision log; proactively identify, assess, assign, escalate, and drive risks, assumptions, issues, and dependencies to resolution.
- Coordinate implementation milestones and dependencies across discovery, design, configuration, integration, testing, training, cutover, go-live, and hypercare.
- Facilitate timely decisions and prevent gaps in understanding by confirming requirements, owners, due dates, handoffs, and acceptance criteria.
- Provide concise status reporting that distinguishes completed work, upcoming work, decisions needed, risks, and client or internal actions.
Testing, Readiness, Go-Live, and Post-Go-Live Support
- Partner with quality assurance, the Business Analyst, technical teams, operations, and the client to define test scenarios and acceptance criteria that trace to approved requirements.
- Support system testing, user acceptance testing, defect triage, validation of fixes, and documentation of client acceptance.
- Assess business and operational readiness, including users, workflows, access, data, configuration, reporting, training, support, and escalation paths.
- Coordinate cutover, go-live, and hypercare activities, including issue triage, clear communications, decision tracking, and stabilization reporting.
- Direct Service Delivery teams and supporting teams to achieve high levels of customer satisfaction. Operate effectively within a matrixed project environment in Closed Loop Execution.
- Ensure all requests, insights, and decisions are acknowledged, documented, and followed through to closure.
- Collaborate transparently across internal teams and communicate externally only after confirming full internal alignment.
- Lead or support escalations with structured discovery, solution proposals, and documented resolution paths
- Remain a knowledgeable client and internal resource after go-live, support the ongoing account and operations teams, and help identify adoption, optimization, and expansion opportunities.
Key Performance Outcomes
- Client requirements are complete, internally validated, traceable, approved, and implemented as intended.
- Implementation artifacts remain current, accurate, organized, audit-ready, and accessible to authorized stakeholders.
- Risks, decisions, issues, assumptions, dependencies, and changes are identified early and driven to timely resolution.
- Client and internal teams have a shared understanding of scope, solution behavior, data requirements, responsibilities, and readiness.
- Testing, go-live, and transition activities are completed with clear evidence, controlled handoffs, and minimal avoidable rework.
- Clients view the role as a credible payment integrity and product advisor throughout implementation and stabilization.
REQUIRED QUALIFICATIONS
- Bachelor's degree in healthcare administration, business, information systems, data analytics, project management, or a related field, or an equivalent combination of education and relevant experience.
- Minimum of five (5) years of progressive experience in healthcare payment integrity, payer claims operations, healthcare technology implementation, business analysis, consulting, or a closely related field.
- Minimum of three (3) 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 multiple domains such as 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 manage multiple priorities, organize complex information, operate with limited direction, and drive accountability across teams without direct authority.
- Proficiency with Microsoft Word, Excel, PowerPoint, Teams, and structured project or requirements management tools.
- Ability to maintain confidentiality and comply with applicable healthcare privacy, security, and data-handling requirements.
- Ability to travel approximately 20 percent, including client-site travel as needed.
PREFERRED QUALIFICATIONS
- Experience implementing payment integrity software or services for national or regional health plans across Commercial, Medicare, Medicaid, or Marketplace lines of business.
- Direct experience with Lyric Replay or similar post-payment audit, recovery, workflow, or analytics platforms.
- Working knowledge of SQL, relational data models, business intelligence tools, data profiling, and reconciliation techniques.
- Experience with claim-adjudication platforms, payer data warehouses, eligibility systems, provider data, clinical records, and recovery systems.
- Experience working in Agile delivery environments and with tools such as Jira, Azure DevOps, Confluence, or comparable platforms.
- Experience developing client-ready implementation playbooks, training materials, process documentation, and operational transition plans.
- PMP, PMI-PBA, CBAP, Lean Six Sigma, Prosci, or Agile certification.
- Payment integrity, coding, clinical, health information management, or claims-related credential appropriate to the candidate's domain background.
***The US base salary range for this full-time position is:
$104,368.00 - $156,551.00
The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. ***
Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success.
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments.
