Jobs at Blue Cross Blue Shield of Massachusetts

Manage municipal account renewals and growth by building relationships with brokers, consultants, and municipal decision-makers. Develop territory strategy, present analytics and proposals, respond to complex RFPs, negotiate pricing, and partner with internal teams to implement plan designs and resolve service issues. Mentor junior AEs and directly influence revenue.

Lead and facilitate regulatory, compliance, and PBM audits; coordinate external auditors and regulators; identify control gaps and improvements; manage findings and corrective action plans; collaborate cross-functionally and maintain audit work papers for executive and Board reporting.

Lead the design, implementation, automation, and operational maturity of enterprise IAM across SSO, MFA, IGA, PAM, and cloud identities. Build integrations, author reference architectures, drive Zero Trust and DevSecOps identity controls, automate with Python/PowerShell/Terraform, mentor engineers, lead incident response and root cause analysis, support audits/compliance, and evaluate IAM technologies and roadmaps.

Design and govern enterprise integration, API, event-driven, and interoperability solutions across cloud, on‑premises, and hybrid environments. Lead architecture reviews, define patterns and standards, run proofs-of-concept for integration and AI-enabled capabilities, and collaborate with engineering, product, security, and stakeholders to deliver scalable, secure, and resilient connectivity for healthcare systems.

The Project Manager will drive AI and automation initiatives within the healthcare sector, managing projects from concept to deployment, while facilitating agile ceremonies and ensuring stakeholder alignment and operational efficiency.

Evaluate medical necessity and appropriateness of outpatient physical therapy services through pre-certification, concurrent, and retrospective reviews; apply clinical guidelines, benefits, and InterQual criteria; coordinate with providers, monitor quality concerns, and ensure regulatory compliance.

Manage daily operations of the Customer Cash Receipts unit, overseeing deposit, reconciliation, and cash application processes. Supervise seven associates, liaise with banks and internal teams, produce month-end journal entries, participate in cross-functional workgroups, and act as subject matter expert for Frontier, CMS/HCR and federal exchange processes. Balance staffing, monitor trends, and manage projects in a high-volume treasury environment.

The AI Solution Architect will design, implement, and optimize AI systems within the Bluefield framework, mentor engineers, and ensure architectural quality.

Provide expert-level financial and membership reporting, write efficient SQL, automate ETL processes, support system design and migrations, and partner with Finance, Sales, and Product teams to deliver monthly, quarterly, and regulatory reports.

Lead and mentor engineering teams for the MyBlue member portal. Drive digital technology solutions, architectural design, and oversee software development lifecycle using Agile methodologies.

The Senior Full Stack Engineer will lead quality assurance strategies, develop automation frameworks, mentor engineers, and contribute to full-stack development while leveraging AI in testing.

Provide corporate and transactional legal support for technology and corporate initiatives, drafting and negotiating complex technology and commercial agreements, advising on AI procurement and data privacy (HIPAA, state laws), supporting governance, investment due diligence, and legal operations improvements.

The Senior Contract Manager leads contract negotiations, manages proposals, analyzes data, collaborates across departments, and ensures contract implementation for healthcare payment models.

Lead large value streams, drive collaboration, and implement technology solutions while managing a team to improve efficiency and outcomes in healthcare delivery.

The Senior Consultant, Advanced Analytics leads analytical projects, optimizes data queries and models, and provides insights to drive performance in healthcare commercial strategies.

Lead complex risk-based audits and consulting projects while advancing the use of AI and analytics in audit processes, providing recommendations to management.

The Director of Business Inclusion and Belonging will develop and implement initiatives to foster a diverse and inclusive environment, manage programs, provide guidance to leaders, and oversee goal tracking mechanisms for inclusion and belonging.

Seeking a Data Scientist to analyze healthcare data, design models, and communicate insights to improve financial outcomes and member care. Requires strong technical expertise and collaboration across functions.

The Director of Risk Adjustment Data and Analytics oversees analytics, reporting, and strategic management of Medicare risk adjustment, ensuring compliance and improving performance. This role leads teams, designs metrics, and drives innovation while collaborating across the organization.

The Director of New Sales will oversee consulting partnerships, drive business growth and member acquisition, manage the sales team, and represent the organization in professional forums.