Blue Cross Blue Shield of Massachusetts

RN Utilization Management Reviewer

Blue Cross Blue Shield of Massachusetts

5 months ago
Hybrid
Full Time
Medior
0 applicants
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Blue Cross Blue Shield of Massachusetts
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About this role

The RN Utilization Management Reviewer is a licensed registered nurse who facilitates care for members with complex needs by authorizing medically necessary services and aligning care with benefit coverage. The role applies managed care principles, medical necessity criteria, and company policies to promote optimal health outcomes. The position works independently and as part of a multidisciplinary clinical team.

Skills

Qualifications

Active RN Licensure (MA)BSN PreferredHigh School Diploma or Equivalent
Blue Cross Blue Shield of Massachusetts

About Blue Cross Blue Shield of Massachusetts

bluecrossma.org

Blue Cross Blue Shield of Massachusetts brings health insurance plans, medical claims, insurance coverage, benefits and telehealth via MyBlue Web & App

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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