RN Utilization Management Reviewer
Blue Cross Blue Shield of Massachusetts
About this role
The RN Utilization Management Reviewer facilitates care for members with complex healthcare needs by authorizing medically necessary services to ensure appropriate levels of care and optimal health. The role operates independently and collaboratively within a multidisciplinary team, applying managed care principles, medical necessity criteria, and company policies. This position is with Blue Cross Blue Shield of Massachusetts and is eligible for remote work with occasional on-site presence in Hingham, MA.
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 MASSACHUSETTS ANNOUNCES LATEST RESULTS
2 weeks ago
GLP-1 weight loss drugs help drive another year of historic losses at Blue Cross Blue Shield of Mass.
2 weeks ago
Blue Cross Blue Shield posts $380M loss, second-largest in its history
2 weeks ago
The Stories: A Thoughtful Look at Innovative Approaches to Corporate Social Responsbility
1 week ago
KATE 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
Unlock Company Insights
View leadership team, funding history,
and employee contacts for Blue Cross Blue Shield of Massachusetts.
Salary
$79k – $96k
per year
More jobs at Blue Cross Blue Shield of Massachusetts
Similar Jobs
RN - Utilization Reviewer - Coordinated Care - PT
University of Mississippi Medical Center
Utilization Review Nurse
Integrated Resources INC
Behavioral Health Utilization Reviewer
Blue Cross and Blue Shield of Louisiana
Utilization Review Nurse - Managed Care
USAJOBS
RN Utilization Management Reviewer
Sagility
Clinical Care Reviewer
Integrated Resources INC