
201 - 500 employees
🏥 Healthcare
💼 Consulting
📦 Logistics
Healthcare • Consulting • Logistics
Lyric is a leading healthcare technology company focused on payment integrity and accuracy solutions. With over 30 years of experience, Lyric aims to simplify the business of care by leveraging machine learning and predictive analytics to empower health plan payers. The company provides a range of solutions, including Lyric 42 Platform, Pre-Pay Editing, Diagnostics Module, Coordination of Benefits, Concept Libraries, and LyricIQ, which combines AI-powered payment accuracy services. Additionally, Lyric focuses on transparency and responsibility in technology development, ensuring enhanced payment accuracy, administrative efficiencies, and reduced provider abrasion. As a trusted partner in the healthcare industry, Lyric continues to deliver cutting-edge technologies at the crossroads of healthcare and fintech, supporting health plans and providers in the shift to value-based care.
🔥 5 minutes ago
🇺🇸 United States – Remote
💵 $104.4k - $156.6k / year
⏰ Full Time
🟠 Senior
🏆 Customer Success
👻 Ghost score 0%
Where this job comes from
Posted on Lyric - Clarity in motion.'s careers page, not through a job board
First seen by Remote Rocketship 5 minutes ago

201 - 500 employees
🏥 Healthcare
💼 Consulting
📦 Logistics
Healthcare • Consulting • Logistics
Lyric is a leading healthcare technology company focused on payment integrity and accuracy solutions. With over 30 years of experience, Lyric aims to simplify the business of care by leveraging machine learning and predictive analytics to empower health plan payers. The company provides a range of solutions, including Lyric 42 Platform, Pre-Pay Editing, Diagnostics Module, Coordination of Benefits, Concept Libraries, and LyricIQ, which combines AI-powered payment accuracy services. Additionally, Lyric focuses on transparency and responsibility in technology development, ensuring enhanced payment accuracy, administrative efficiencies, and reduced provider abrasion. As a trusted partner in the healthcare industry, Lyric continues to deliver cutting-edge technologies at the crossroads of healthcare and fintech, supporting health plans and providers in the shift to value-based care.
• 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 • Advise clients on implementation choices, workflow design, and practical tradeoffs • Own the end-to-end requirements lifecycle, documentation, traceability, validation, change control, and formal approval • Translate client needs into requirements, process flows, user stories, acceptance criteria, data specifications, and configuration decisions • Maintain implementation artifacts including requirements, workflow documentation, data dictionaries and mappings, decision logs, RAID logs, action trackers, test evidence, approvals, training materials, and transition documentation • Serve as an expert resource across post-payment payment integrity, including COB, data mining, DRG review, coding or clinical chart review, provider outreach, overpayment validation, recovery, appeals, reconciliation, and reporting • Explain Lyric Replay product capabilities, workflows, configuration options, dependencies, limitations, and expected user experience • Lead discovery and validation of claims, member, eligibility, provider, benefit, contract, payment, clinical, recovery, and reference data • Document source-to-target mappings, transformation rules, default values, exclusions, reconciliation logic, and data-quality expectations • Act as the communication bridge between clients and Lyric product, Business Analysis, engineering, data, configuration, QA, security, operations, and customer success teams • Maintain RAID and decision logs and drive risks, assumptions, issues, and dependencies to resolution • Coordinate milestones across discovery, design, configuration, integration, testing, training, cutover, go-live, and hypercare • Define test scenarios and acceptance criteria; support system testing, UAT, defect triage, fix validation, and client acceptance • Assess readiness and coordinate cutover, go-live, hypercare, issue triage, communications, decision tracking, and stabilization reporting • Direct service delivery and supporting teams to achieve customer satisfaction • Lead or support escalations with structured discovery, solution proposals, and documented resolution paths • Remain engaged after go-live to support adoption, optimization, expansion opportunities, account teams, and operations
• 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 across domains such as COB, data mining, DRG review, coding or clinical chart review, overpayment recovery, appeals, and reconciliation • 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, 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 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: experience with payment integrity software or services for health plans; Lyric Replay or similar platforms; SQL, relational data models, business intelligence tools, data profiling, and reconciliation; claim-adjudication platforms and payer systems; Agile environments and Jira, Azure DevOps, or Confluence; implementation playbooks and training materials; PMP, PMI-PBA, CBAP, Lean Six Sigma, Prosci, or Agile certification; payment integrity, coding, clinical, health information management, or claims-related credential
• Equal Opportunity Employer committed to an inclusive environment • Collaborative success environment
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