RN Manager, Case Management / Utilization Management
Blue Cross Blue Shield of Massachusetts
Full-time
other-general
Location
Hingham, MA, United States
Posted
July 18, 2026
Job Description
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.
+ Execute a forward-thinking utilization management strategy that aligns with the company's goals.
+ Lead performance management, including hiring, professional development, mentorship, and performance evaluations to build a hig...
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.
+ Execute a forward-thinking utilization management strategy that aligns with the company's goals.
+ Lead performance management, including hiring, professional development, mentorship, and performance evaluations to build a hig...