Physician Reviewer (Physician Review Unit)
Blue Cross Blue Shield of Massachusetts(2 months ago)
About this role
A Physician Reviewer at Blue Cross Blue Shield of Massachusetts is a board-certified physician who supports utilization management and clinical decision-making for member care and coverage determinations. The role is based in the Physician Review Unit and contributes to clinical leadership, quality assurance, and regulatory compliance across the organization.
Required Skills
- Clinical Judgment
- Medical Policy
- Utilization Management
- Peer Outreach
- Case Review
- Documentation
- Provider Communication
- Care Coordination
- EMR Access
- Microsoft Office
Qualifications
- MD or DO
- Specialty Board Certification
- Unrestricted Massachusetts Medical License
- Active Clinical Practice
About Blue Cross Blue Shield of Massachusetts
bluecrossma.orgBlue Cross Blue Shield of Massachusetts brings health insurance plans, medical claims, insurance coverage, benefits and telehealth via MyBlue Web & App
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