Blue Cross And Blue Shield Of Massachusetts

RN Manager, Case Management / Utilization Management

Hinghamonsitemanager$105K – $128K

Posted today · via Workday

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About this role

Ready to help us transform healthcare? Bring your true colors to blue. The Role We are seeking a dynamic leader to join our team as the Manager, Clinical Review. This role directs the utilization review clinical team operations for our Commercial plans. The manager will lead a clinical team, foster a culture of excellence, and ensure delivery of medically necessary, high-quality, and cost-effective care. This position is accountable for maintaining rigorous compliance with all regulatory and accreditation standards while driving strategic initiatives to improve member outcomes. Key Responsibilities Strategic & Team Leadership Provide decisive leadership and direct supervision to a clinical staff team.…

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What we'd score you on

reqspace match rubric

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Skills match

For this role: less, teams

Level fit

This role is manager-level. We check your trajectory against it.

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

Location fit

This role is based in Hingham. We weight your proximity and willingness to relocate.

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