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28

Jobs at Blue Cross Blue Shield of Massachusetts

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$84K - $103K *

The Appeals Nurse Reviewer is responsible for reviewing provider claims appeals, validating coding and medical necessity of services, and pricing claims according to guidelines. This role requires str...

3 days ago

  •   Less than 5 years exp.  •   Healthcare

$115K - $141K *

The Clinical Pharmacist Reviewer is responsible for reviewing formulary exception, prior authorization, and quantity limit exception requests from providers for various pharmacy benefits. This role in...

4 days ago

  •   5 - 7 years exp.  •   Healthcare

$90K - $110K *

The Prepayment Review Coding Specialist is responsible for reviewing medical records to identify instances of healthcare fraud, waste, and abuse, ensuring accurate claim payments. This role involves c...

1 week ago

  •   5 - 7 years exp.  •   Healthcare

$74K - $94K *

The Clinical Registered Dietitian is responsible for coordinating and arranging services to support members in their health journey. This role involves assessing nutritional needs, collaborating with...

1 week ago

  •   Less than 5 years exp.  •   Healthcare

$106K - $130K *

The Ancillary Contract Manager will develop, manage, and execute contracting strategies for the ancillary provider network at Blue Cross Blue Shield of Massachusetts. This role involves negotiating co...

1 week ago

  •     Healthcare

$106K - $130K *

The Ancillary Contract Manager will develop, manage, and execute contracting strategies for the ancillary provider network at Blue Cross Blue Shield of Massachusetts. This role involves negotiating co...

1 week ago

  •     Healthcare

$100K - $129K *

The Compliance Project Manager is responsible for supporting the Mental Health Parity compliance program and managing various compliance projects. This role involves tracking program status, managing...

2 weeks ago

  •   Less than 5 years exp.  •   Healthcare

$79K - $97K *

The Clinical Utilization Reviewer is responsible for facilitating care for members with complex healthcare needs by authorizing medically necessary services. This role involves conducting clinical rev...

2 weeks ago

  •   Less than 5 years exp.  •   Healthcare

$123K - $155K *

The Senior Manager, Network Contracting is responsible for leading negotiations for a portfolio of hospital and physician contracts, focusing on innovative payment models and quality incentive program...

2 weeks ago

  •   5 - 7 years exp.  •   Healthcare

$199K - $244K *

The Director of Enterprise Architecture will lead the development and implementation of the company's technology architecture, ensuring alignment with business objectives and driving innovation. This...

2 weeks ago

  •   8 - 10 years exp.  •   Healthcare

$133K - $163K *

The Systems Database Engineer is responsible for implementing and supporting the Enterprise Database Environment, with a primary focus on PostgreSQL and secondary focus on Microsoft SQL Server. This r...

2 weeks ago

  •   8 - 10 years exp.  •   Healthcare

$292K - $366K *

The Vice President of Underwriting will lead and oversee the underwriting function at Blue Cross Blue Shield of Massachusetts, ensuring strategic alignment with business goals and risk management obje...

2 weeks ago

  •   8 - 10 years exp.  •   Healthcare

$232K - $289K *

The Physician Reviewer is responsible for evaluating clinical service requests made by BCBSMA members and providers, using clinical judgment to determine coverage appropriateness. This role involves p...

3 weeks ago

  •     Healthcare

$102K - $125K *

The Network Contract Leader is responsible for negotiating and managing contracts with hospital and physician organizations, focusing on innovative payment models and quality incentive programs. This...

1 month ago

  •   Less than 5 years exp.  •   Healthcare

$111K - $135K *

The Senior Product Owner will play a crucial role in delivering innovative healthcare solutions throughout the product lifecycle, collaborating with business partners and agile teams to prioritize imp...

1 month ago

  •   5 - 7 years exp.  •   Healthcare

$111K - $135K *

The Senior Product Owner will play a crucial role in delivering innovative healthcare solutions throughout the product lifecycle, collaborating with business partners and agile teams to prioritize imp...

1 month ago

  •   5 - 7 years exp.  •   Healthcare

$84K - $103K *

The Clinical Care Manager is responsible for facilitating care for members with rising health risks or complex healthcare needs, promoting optimal health through assessment and coordination of care. T...

Reposted 1 month ago

  •   Less than 5 years exp.  •   Healthcare

$112K - $137K *

The Project Manager, Data Governance is responsible for executing data governance projects and initiatives, ensuring alignment with organizational goals and compliance requirements. This role involves...

1 month ago

  •   5 - 7 years exp.  •   Healthcare

$112K - $137K *

The Project Manager, Data Governance is responsible for executing data governance projects and initiatives, ensuring alignment with organizational goals and compliance requirements. This role involves...

1 month ago

  •   5 - 7 years exp.  •   Healthcare

$76K - $93K *

The Clinical Care Manager is responsible for facilitating care for members with rising health risks or complex healthcare needs, promoting optimal health through assessment and coordination of care. T...

2 months ago
dated job explanation
  •   Less than 5 years exp.  •   Healthcare

$243K - $297K *

The Vice President of Corporate Communications is responsible for leading the Corporate Communications function, setting quality standards, and ensuring operational efficiency. The role involves reput...

2 months ago
dated job explanation
  •   8 - 10 years exp.  •   Healthcare

$133K - $163K *

Senior IA Engineer responsible for driving the development and implementation of automation solutions using Intelligent Automation tools and technologies, collaborating with stakeholders, and ensuring...

More than 3 months ago
dated job explanation
  •   5 - 7 years exp.  •   Healthcare

$133K - $163K *

Senior IA Engineer responsible for driving the development and implementation of automation solutions using Intelligent Automation tools and technologies, collaborating with stakeholders, and ensuring...

Reposted more than 3 months ago
dated job explanation
  •   5 - 7 years exp.  •   Healthcare

$161K - $197K *

The Enterprise Application Security Architect at Blue Cross Blue Shield of Massachusetts will be responsible for defining and implementing enterprise-level security solutions, ensuring alignment with...

Reposted more than 3 months ago
dated job explanation
  •   8 - 10 years exp.  •   Healthcare

$161K - $197K *

The Enterprise Application Security Architect at Blue Cross Blue Shield of Massachusetts will be responsible for defining and implementing enterprise-level security solutions, focusing on preventative...

Reposted more than 3 months ago
dated job explanation
  •   8 - 10 years exp.  •   Healthcare