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What We Need
Reporting to the Associate Director of Professional Reimbursement Strategy, the Payment Policy and Network Coding Sr. Manager is responsible for leading the research development, proposal, implementation, and maintenance of BCBSMA's Corporate Payment Reimbursement Policies, Enterprise Code Repository Database, Annual & Quarterly HCPC/ICD10 code updates, Clinical Code Edit Solutions and Medical Cost Saving Goals.
Core functions include acting as a clinician/clinical coder & subject matter expert (SME) for all reimbursement strategy initiatives and project manages all end-to-end operational & implementation activities. This role will also be responsible for the benchmark, proactively monitor and translate industry standard payment reimbursement policies from HHS Federal Register, CMS Policy, local/national plans and facilitate with internal stakeholders to assess organizational impact and develop recommendations to management for resolution.
This role is eligible for our Flex persona.
Your Day to Day
*This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties.
We're Looking for
What You Bring
It is our mission at Blue Cross Blue Shield of Massachusetts to foster a culture that enables associates to do their best work while living happy and healthy lives. That's why we offer you a variety of ways to support your best physical, emotional, financial, and social well-being. For more information on our benefit offerings, visit
#LI-Hybrid
Minimum Education Requirements:High school degree or equivalent required unless otherwise noted above
LocationBoston, HinghamTime TypeFull timeSalary Range: $120,600.00 - $147,400.00The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
This job is also eligible for variable pay.
We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
WHY Blue Cross Blue Shield of MA?
We understand that theandcan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.
As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourpage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourto stay "in the know" on all things Blue.
At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "" Page.
Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.Full Time
Insurance
$99k-132k (estimate)
03/13/2024
05/12/2024
bluecrossma.com
BOSTON, MA
1,000 - 3,000
1937
Private
ANDREW DREYFUS
$1B - $3B
Insurance
3Derm is a medical device company that manufactures skin imaging and diagnostic systems for the dermatology industry.