Jobs at Blue Cross Blue Shield of Massachusetts

Manage HIOS, RBIS, and Department of Insurance filings; maintain health plan product and contract data; develop policy forms; implement regulatory and legislative changes; analyze benefit requests; and coordinate cross-functional teams to ensure accurate, timely regulatory submissions and operational compliance.

Manage the end-to-end development, maintenance, and implementation of account agreements and amendments. Ensure contract language complies with operational requirements and health insurance laws, coordinating with Legal, Underwriting, Contracts Delivery, leadership, and analysts. Lead cross-functional projects, assign tasks, manage timelines and milestones, support product and corporate initiatives, and oversee agreement renewals and implementations. The role requires strong communication, analytical, problem-solving, consultative, and supervisory or project leadership skills.

Leads third-party and technology risk assessments across vendors, applications, systems, and business processes. Evaluates contractual safeguards, compliance obligations, vulnerabilities, and emerging risks, translating technical findings into actionable business guidance and executive dashboards. Partners with Legal, Procurement, Information Security, and business stakeholders on mitigation strategies, HIPAA compliance, governance, KRIs, policy development, remediation tracking, and risk program improvements. Mentors colleagues and advises teams on embedding risk management throughout initiative planning and delivery.

Sells, retains, and cross-sells commercial medical, dental, and ancillary insurance products through inbound and outbound telesales. Builds broker and account relationships, identifies customer needs, presents consultative solutions, manages renewals, meets sales and retention quotas, supports technology and manual renewal processes, collaborates with underwriting and internal teams, and complies with applicable regulations.

Lead AI engineering teams developing scalable agentic AI solutions. Responsibilities include technical leadership, architecture and implementation of AI agents, Generative AI and RAG integrations, production model reliability, code quality, delivery planning, troubleshooting, mentoring, and evaluating new technologies. The role requires machine learning experience with TensorFlow, PyTorch, and scikit-learn, cloud and MLOps expertise, and strong collaboration skills.

Provides executive-level administrative support to the Corporate Communications & Citizenship leadership team. Manages complex calendars, meetings, travel, expenses, communications, office operations, vendor contracts, purchase orders, invoices, budgets, files, SharePoint sites, and divisional initiatives. The role requires discretion, initiative, strong organizational and relationship-building skills, advanced Microsoft Office proficiency, and the ability to manage competing priorities and confidential information.

Leads provider engagement and risk adjustment improvement strategies across a health plan network. Partners with provider leaders, analytics, contracting, quality, and medical management teams to identify documentation and coding opportunities, improve performance, and support value-based care objectives. Provides expertise on CMS HCC methodologies, ICD-10-CM guidelines, regulatory changes, and compliance. Develops executive dashboards, manages multi-year initiatives, and influences stakeholders without direct authority.

Conduct member outreach to close HEDIS and STARs care gaps, schedule and confirm appointments, coordinate provider communications, identify barriers to care, make referrals, assist with benefits and MyBlue registration, document interactions, and support clinical quality improvement activities and medical record reviews.

Leads the health insurance underwriting function and a 60-person team, overseeing risk assessment, pricing models, underwriting guidelines, audits, regulatory compliance, and complex medical applications for individual and group plans. Partners with actuarial, finance, sales, legal, brokers, and executive stakeholders to optimize risk selection, pricing, customer support, and growth. Requires extensive health insurance underwriting leadership, healthcare expertise, analytical proficiency, and a bachelor's degree.

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.

Supports the strategy, development, implementation, and ongoing management of healthcare products, especially HSAs, FSAs, and other funding solutions. Leads cross-functional initiatives, gathers requirements, tracks KPIs, supports business cases and financial analysis, ensures regulatory alignment, and serves as a product expert for Sales, brokers, and account teams. Monitors market feedback and product performance while identifying enhancement opportunities and coordinating with vendors and internal stakeholders.

Coordinate and support product lifecycle activities for healthcare products: assist Product Managers with assessments and implementations, maintain JIRA/SharePoint trackers, manage timelines/risks, support sales/marketing collateral and regulatory filings, track KPIs, and collaborate across cross-functional teams and vendors.

Support product lifecycle and operational readiness for healthcare products by coordinating cross-functional projects, documenting requirements and KPIs, maintaining JIRA/SharePoint trackers, facilitating meetings, tracking vendor deliverables, supporting regulatory filings and reporting, and assisting Sales/Marketing with product collateral and RFP responses. Ensure process standardization and compliance while driving continuous improvement across teams.

Deliver competitive intelligence and market insights through secondary and select primary research, data visualization, and stakeholder presentations to inform strategic planning and initiatives across the organization.

Lead state and federal legislative strategy and advocacy for BCBSMA on healthcare and insurance policy. Analyze legislation, draft policy, build coalitions, testify before regulators/legislatures, advise senior leaders, manage PAC responsibilities, and coordinate internal implementation and stakeholder engagement on issues like behavioral health, substance use disorder, prescription drug pricing, and provider payment policy.

The AI Product Owner guides AI engineering teams, ensuring technical excellence, mentoring engineers, overseeing solution design, and driving timely delivery of high-quality AI products.

Lead AI Engineer to mentor teams, guide AI solution design, ensure code quality, and manage complex AI projects while evaluating new technologies.

Lead the AI Engineering team to define technical architecture, mentor engineers, drive innovation, and ensure robust and scalable AI solutions.

Provide legal counsel on vendor and provider contracts, regulatory compliance (especially Medicare), data privacy/security, and government programs. Draft and negotiate agreements, review communications, identify legal risks, support Procurement and Network Contracting, and manage legal projects for BCBSMA.

Manage and grow a territory of employer accounts (51+ employees) through consultative sales, broker relationships, renewal negotiations, and promoting BCBSMA products. Partner with internal teams to resolve issues and deliver concierge-level service while meeting retention and growth goals.