Program Manager, Clinical Compliance
Blue Cross Blue Shield of Massachusetts
About this role
The Medicare Clinical Program Manager is responsible for overseeing Medicare utilization management compliance and CMS audit readiness within Health and Medical Management (HMM). The role supports evaluation and reporting for HMM and its delegates and contributes to organizational preparedness for regulatory reviews. It is part of the HMM Quality and Compliance team and leverages a clinical background to align practices with CMS requirements.
Skills
Qualifications
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
Recent company news
Blue Cross Blue Shield of MassachusettsBLUE CROSS BLUE SHIELD OF MASSACHUSETTS ANNOUNCES LATEST RESULTS
2 weeks ago
The Boston GlobeGLP-1 weight loss drugs help drive another year of historic losses at Blue Cross Blue Shield of Mass.
2 weeks ago
The Business JournalsBlue Cross Blue Shield posts $380M loss, second-largest in its history
2 weeks ago
CSRwireThe Stories: A Thoughtful Look at Innovative Approaches to Corporate Social Responsbility
1 week ago
PR NewswireKATE WALSH ELECTED TO BLUE CROSS BLUE SHIELD OF MASSACHUSETTS BOARD OF DIRECTORS
Dec 9, 2025
About Blue Cross Blue Shield of Massachusetts
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Leadership Team
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
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View leadership team, funding history,
and employee contacts for Blue Cross Blue Shield of Massachusetts.
Salary
$95k – $117k
per year