Remote
Compensation
Position Level
Industries
Locations
More
$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
$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
Prepayment Review Coding Specialist
$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
$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
$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
$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
$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
Utilization Management Reviewer - Behavioral Health
$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
Senior Manager, Network Contracting
$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
Director of Enterprise Architecture
$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
$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
Vice President of Underwriting
$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
$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
$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
$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
$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
$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
Project Manager, Data Governance
$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
Project Manager, Data Governance
$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
Case Manager Behavioral Heatlh
$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...
Vice President, Corporate Communications
$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...
Senior Intelligent Automation Engineer
$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...
Senior Intelligent Automation Engineer
$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...
Enterprise Application Security Architect
$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...
Enterprise Application Security Architect
$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...