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    Blue Cross Blue Shield New Mexico (off)
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22 Jobs Found
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RN Sr Supervisor Managed Care Programs - Centennial Care UM

Job type: Full-Time

BASIC FUNCTION: This position is responsible for supervising, training and monitoring the daily operations of clinical staff in the evaluation and...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
11 hours ago

Medical Mgmt Specialist II

Job type: Full-Time

BASIC FUNCTION: This position is responsible for conducting medical management and health education programs for customers on government health car...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Behavioral Health Care Coordinator

Job type: Full-Time

BASIC FUNCTION: This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity incl...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Sr Sup Managed Care Programs - MAPD

Job type: Full-Time

JOB PURPOSE: This position is responsible for supervising and monitoring the Utilization Management (UM) staff in the evaluation and review of case...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

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RN - Care Coordinator UM/CM I

Job type: Full-Time

BASIC FUNCTION: This position is responsible for performing concurrent review in accordance with approved departmental guidelines; performing disch...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Mgr Pharmacy Program Oprs

Job type: Full-Time

BASIC FUNCTION: This position is responsible for Pharmacy Operations Unit enterprise-wide which includes staff in multiple states; developing strat...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Health Coordinator

Job type: Full-Time

BASIC FUNCTION: This position is responsible for contacting members to inform and educate them on our medical management programs; conducting resea...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Unit Manager Clinical Operations - NM Government Programs

Job type: Full-Time

Job Purpose: This position is responsible for supervising staff involved in a variety of medical management operations.. Responsible for hiring, tr...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
2 days ago

Manager Government Program Appeals

Job type: Full-Time

BASIC FUNCTION: This position is responsible for oversight, managing and monitoring of appeals and grievance functions for the provider and member...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
4 days ago

RN - Sr Supervisor Managed Care Programs - Utilization Management

Job type: Full-Time

BASIC FUNCTION: This position is responsible for supervising, training and monitoring the daily operations of clinical staff in the evaluation and...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
4 days ago

Medical Management Trainer

Job type: Full-Time

BASIC FUNCTION: This position is responsible for developing and performing the clinical, non clinical, and systems training; new employee orientati...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Internal Provider Network Representative

Job type: Full-Time

BASIC FUNCTION: This position is responsible for providing assistance to practitioners in resolution of claims, pricing, coding and contract issues...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Medical Management Specialist I - Centennial Care - Case Management

Job type: Full-Time

JOB PURPOSE:This position is responsible for conducting medical management and health education programs for customers on government health care pr...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Medical Management Accreditation & Audit Coordinator

Job type: Full-Time

BASIC FUNCTION: This position is responsible for conducting audits as well as monitoring ongoing quality improvement activities within the Medical...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Behavioral Health Care Coordinator - Case Management

Job type: Full-Time

BASIC FUNCTION: This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity incl...

Blue Cross Blue Shield New Mexico  
NM - Las Cruces
5 days ago

Medical Reviewer LPN

Job type: Full-Time

BASIC FUNCTION: This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteri...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Medical Management Specialist I - Special Beginnings

Job type: Full-Time

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care p...

Blue Cross Blue Shield New Mexico  
NM - Alamogordo
5 days ago

Community Outreach Specialist I/Native American Liaison

Job type: Full-Time

BASIC FUNCTION: This position is responsible for developing and maintaining cooperative working relationships with the New Mexico Native American p...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Clinical Pharmacist

Job type: Full-Time

****POSITION IS LOCATED IN ALBUQUERQUE, NM**** BASIC FUNCTION: This position is responsible for assisting in the development, implementation and ma...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
5 days ago

Sr Mgr Medicaid Clinical Prog

Job type: Full-Time

BASIC FUNCTION: This position is responsible for managing staff accountable for leading projects and coordination of the Medicaid regulations and p...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
28 days ago

Reporting Specialist

Job type: Full-Time

BASIC FUNCTION: This position is responsible for gathering data, analyzing data, and preparing reports including disseminating information from var...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
29 days ago

Sr Manager Quality Improvement

Job type: Full-Time

JOB PURPOSE: This position is responsible for managing staff responsible for quality improvement projects and providing leadership and consultation...

Blue Cross Blue Shield New Mexico  
NM - Albuquerque
30 days ago

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