Ready to help us transform healthcare? Bring your true colors to blue. The Role The Claims Nurse Reviewer is responsible for reviewing claims, validating coding and medical necessity of the services submitted and pricing the claims according to appropriate guidelines. This position requires strong clinical and medical coding skills to review claims for medical necessity,

Ready to help us transform healthcare? Bring your true colors to blue. Reporting to the SVP, Sales & Client Management, the Director, Group Medicare Sales, is an integral member of the leadership team driving BCBSMA's purposeful re entry into the Group Medicare Advantage Market . The role will have responsibility for Group Medicare Advantage and Medicare Supplementary new

Ready to help us transform healthcare? Bring your true colors to blue. What we need The Health Engagement Coordinator is a strategic partner to the Health Engagement Strategist (HES) to successfully implement and run health engagement programs for clients across all markets. The HEC will participate in account meetings and develop and maintain a strong working relationshi

Ready to help us transform healthcare? Bring your true colors to blue. The Role Reporting to Senior Vice President of Government Programs, the VP Product is responsible for developing and implementing Medicare and Federal Employee Program (FEP) products that result in achieving membership and margin targets for the Government Line of Business. This leader will work with i

Ready to help us transform healthcare? Bring your true colors to blue. The Role The Clinical Care Manger is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. This position is self directed and works independently and collaboratively to facilitate care based on the

Ready to help us transform healthcare? Bring your true colors to blue. The Role The Clinical Care Manager LPN is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. Under the direction of an RN , the LPN CM works collaboratively with the entire Clinical Care manageme

Ready to help us transform healthcare? Bring your true colors to blue. What We Need Lead Data Engineer is a staff member of Operational Data Solutions Delivery team. This role will lead solutioning and implementation of data and integration needs of digital & omni channel platforms at BCBSMA This role will work closely with other technology partners to build highly availa

Ready to help us transform healthcare? Bring your true colors to blue. What we need The Sales Support Consultant plays a critical part in enabling the BCBSMA strategy to drive profitable growth, create exceptional consumer experiences and be the plan partner of choice. This internally and externally facing role will work closely with the Sales Directors in National Sales

Ready to help us transform healthcare? Bring your true colors to blue. What We Need We are looking to add a Technical Portfolio Consultant to our team! We need someone with experience in Product Management, Lean Portfolio Agile Development, and has experience with understanding, quantifying and documenting Value for key Portfolio Initiatives. This person will support our

Ready to help us transform healthcare? Bring your true colors to blue. What We Need At BCBSMA, we are seeking an experienced Lead Full Stack Engineer to drive our cutting edge technology initiatives in an agile environment. As a hands on leader, you will guide the end to end development process, ensuring the delivery of high quality solutions. Your role involves collabora

Ready to help us transform healthcare? Bring your true colors to blue. What We Need At BCBSMA, we are seeking an experienced Lead Full Stack Engineer to join our dynamic support team, where your expertise will be pivotal in ensuring the seamless operation and support of our cutting edge portfolio of healthcare software solutions. This role represents a strategic successio

Ready to help us transform healthcare? Bring your true colors to blue. The Senior Director, Federal Government Affairs will manage BCBSMA activities to achieve effective and time sensitive advancement of BCBSMA legislative and regulatory agenda in a coordinated and integrated fashion. In this role, you will work closely with the Vice President, State and Federal Governmen

Ready to help us transform healthcare? Bring your true colors to blue. A Commercial Corporate Insurance Senior Manager is responsible for overseeing and managing the insurance needs of a company. This includes renewing existing coverages, developing and implementing insurance strategies, negotiating policies terms and conditions, assessing new initiatives for potential ri

Ready to help us transform healthcare? Bring your true colors to blue. Do you stand for something? For the right things. For listening to the person who has no voice. For believing you can make things better. We're Blue Cross, and we're for big changes, starting right now. We're taking the lead in transforming health care for tomorrow. And together, we'll take our passion

Ready to help us transform healthcare? Bring your true colors to blue. The Business Analyst, Information Security works within the End User Behavior & Analytics (EUBA) Team & will be the primary technical and operational point of contact for the full stack of core reporting, user training, simulations and metrics related to their activities. This BA will understand the nu