Blue Cross Blue Shield of Massachusetts Jobs & Careers

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7 Blue Cross Blue Shield of Massachusetts jobs found on Monster.

Jobs 1 to 7 of 7
Blue Cross Blue Shield of Massachusetts Quincy, MA, 02171
Description: Major Responsibilities: The Associate Medical Director for Behavioral Health is a senior physician manager who is responsible for the management, quality, and effectiveness of physician and psychologist review of clinical services requests and appeals within the Behavioral Health division of the Physician Psychologist Review Unit. This senior physician is actively involved in implemen...
Blue Cross Blue Shield of Massachusetts North Quincy, MA, 02171
Blue Cross Blue Shield of Massachusetts is looking for a Data Specialist to join our Corporate Peer Review team in Quincy, MA. This is a terrific opportunity for a systems savvy healthcare industry professional to join a well-established team and grow at Blue Cross Blue Shield of MA. This role reports to the Director of Corporate Peer Review, Health & Medical Management Division. About Blue Cross...
Blue Cross Blue Shield of Massachusetts Boston, MA, 02215
Job Description This position serves as a data analyst within the Fraud Investigation & Prevention unit. This position reports directly to a Manager in the development of investigation targets, makes recommendations for software updates and changes, supports the analytical software programs and assures the availability during business hours. This position will work with a variety of business areas...
Blue Cross Blue Shield of Massachusetts North Quincy, MA, 02171
Job Description Blue Cross Blue Shield of Massachusetts is looking for a Manager, Application Development to join our IT organization and be based in Quincy, MA office. This is a terrific opportunity for a hands-on application development manager with SOA expertise to help lead our enterprise wide transformation to shared services model. As a talented and seasoned manager, you will be involved in...
Blue Cross Blue Shield of Massachusetts Boston, 02215
Position Summary: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and targeted intervention to promote optimal, cost-effective outcomes. The function of this position is to assist Members in the administration of their health plan benefits. The Case Manager focus...
Blue Cross Blue Shield of Massachusetts Boston, MA, 02215
Position Summary: This Analyst is responsible for the development, analysis and implementation of Provider Informatics reporting. He/she plays an active role in the support of existing and emerging provider contract models, including synthesis and analysis of data used for performance-based incentive programs; supporting requirements and testing of new analytical systems and processes; and providi...
Blue Cross Blue Shield of Massachusetts Hingham, MA
Position Summary This position is responsible for implementation, oversight and process improvements of the HCC (Hierarchical Condition Categories) risk adjustment medical record review process to ensure correct medical diagnosis are submitted to CMS. The Risk Adjustment Manager leads a team of certified coders and works in collaboration with business support staff to meet divisional goals while i...
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