AMVETS Jobs

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Credentialing & Peer Review’s Project Manager is responsible for staff support, administrative and project management, quality improvement, and overseeing continuing medical education in a dynamic business environment. This position leverages strategic project management skills, interpersonal communication, independent problem-solving and organizational skills to develop and coordinate projects related to credentialing, peer review, continuing medical education, and any other HMM operational priorities.. In addition to project management, this role manages policy manual development, Credentials & Peer Review Committee preparation and scheduling, and serves as Blue Cross’ CME Coordinator. Additional responsibilities include but are not limited to supporting efforts to continually improve data capabilities, including file audits and quality of departmental analysis and reporting using Credentialing and Peer Review systems.

This position is eligible for the Flex persona, with in office expectations for local candidates 2 days per week. This may change depending on business needs.

Your Day to Day

As an integral part of the Credentialing & Peer Review (CPR) Team, the Project Manager works closely with CPR’s Director, , the Senior Credentialing Manager, and the Credentialing & Peer Review teams. This role is inherently cross-functional, collaborating with Network Management, Legal Counsel, and other HMM teams to achieve operational success. Key responsibilities include:

• Manage projects and initiatives by overseeing all aspects of the project lifecycle, developing project-related deliverables, and proactively tracking action items until completion;

• Plan and oversee meetings, utilizing effective communication and presentation skills to interface with team members and subject matter experts to support team goals and project efforts;

• Manage Blue Cross Grand & Schwartz Rounds for 1,200+ attendees annually, ensuring high-impact programming and synthesizing continuing education for internal MD’s;

• Develop and maintain CPR’s policy manual, team workflows, job aids, and process improvements to maximize operational efficiency; and

• Lead regulatory responsibilities, including coordinating documentation for NCQA survey assessment, creating delegation policy reviews, updating the Provider Central, and preparing quarterly CPR/Credentialing Dashboard.

We are Looking for

• Experienced at delivering successful projects and optimizing healthcare workflows;

• Fast, meticulous learner with excellent analytical, organizational, and research skills;

• Ability to work with a diverse group of stakeholders to achieve results and meet deadlines;

• Expertise with Microsoft office required (proficiency with other project management software a plus); and

• Demonstrated organizational skills with ability to independently work under pressure and manage multiple, varied tasks to prioritize workload effectively in a demanding environment and deliver high-impact results.

What You Bring

• Bachelor’s degree in health care administration or related field required;

• Master’s degree or equivalent in healthcare administration preferred;

• Three to five years’ experience in managed care or the health care delivery system preferred; and

• Familiarity with state and federal regulations and NCQA accreditation standards.

What You will Gain

• Contribution to the Credentials & Peer Review mission to support the delivery of high-quality, cost-effective health care for our members by ensuring BCBSMA offers a qualified network of providers through nationally recognized (re)credentialing and peer review standards.

• Opportunity to be in an inclusive and rewarding workplace that promotes excellence and provides opportunities for associates to forge their unique career path. Recognition that you are a subject matter expert in all matters concerning (re) credentialing and peer review.

• Increased potential for advancement in any healthcare environment.

#LI-HYBRID

Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above

LocationBoston, HinghamTime TypeFull time

Salary Range: $81,450.00 - $99,550.00

The 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 the confidence gap (https://www.theatlantic.com/magazine/archive/2014/05/the-confidence-gap/359815/) and imposter syndrome (https://www.braintreepayments.com/blog/overcoming-imposter-syndrome/) can 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 our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community (https://careers.bluecrossma.org/us/en/jointalentcommunity?applyType=JTC) to 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 "How We Work (https://careers.bluecrossma.org/us/en/how-we-work) " Page.

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Our Commitment to You

We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.

Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. 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.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.