Ready to help us transform healthcare? Bring your true colors to blue. This is a part time position with an expectation of working 4 hours per week. The Role This part time position is responsible for the clinical integrity, accuracy and consistency of our dental service reviews. The consultant evaluates documentation for clinical dental services submitted under various CDT codes to ensure they represent necessary and appropriate care for our members. These reviews can occur as pre-treatment estimates, claim submissions after the services have been completed or as appeals to initial denials. In performing these duties, the dental consultant will collaborate with cross-functional team members for consultation and advice, ensuring all reviews are conducted thoroughly and in accordance with our established guidelines. Collaboration is performed through various channels including but not limited to emails, phone calls, internal systems and meetings. Excellent communication skills are essential, as the consultant will also contact submitting providers as needed to clarify documentation or deliver determination notifications. Your Day to Day 1. A primary responsibility is to evaluate the clinical necessity, appropriateness, and efficacy of dental procedures requested or performed. This involves using a set of formal techniques to review the dental care request and collaboration with others for proper adjudication. The expectation would be the ability to daily review the limited clinical assignments so that adjudications can be made on a timely basis in accordance with regulatory standards. 2. Collaborate with various business areas to offer guidance and solicit input into clinical policies. This collaboration would be primarily with dental utilization reviewers from claim operations and dental network managers from our network contracting division. 3. Interact with dental providers when there is a question about the documentation submitted for claim predetermination or review to assure all necessary information is being considered before adjudication. 5. Represent Dental Blue at professional meetings and maintain active involvement with organized dentistry. 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: Strong Clinical Foundation: A robust clinical background in dentistry is essential. This candidate would be a licensed dentist in Massachusetts, preferably with extensive experience in a clinical setting. This practical experience is vital for making credible assessments of the necessity and appropriateness of various dental treatments and procedures. Keen Analytical and Critical-Thinking Abilities: The position demands strong analytical skills to interpret and apply clinical guidelines to specific cases. A candidate must be proficient in evaluating dental records, treatment plans, and other clinical data to make objective, evidence-based decisions. Unyielding Ethical Standards: Given the nature of the role, which involves making determinations that impact patient care, a high degree of ethical integrity is necessary. The consultant must be capable of making judgments that are impartial and consistent with our policy of fair reviews. Exceptional Communication Skills: Effective communication skills are important for this role. The consultant will need to interact with dental providers to request additional information or to provide clarification on review decisions. The ability to engage in clear and professional dialogue is essential. Meticulous Attention to Detail: The review process is detail-oriented and requires a methodical approach. A candidate should be highly organized and thorough to ensure that all relevant information is considered and accurately documented and responded to in a timely manner. What You Bring: Education - Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD): A foundational requirement for this position is a degree from an accredited dental school and a current unrestricted dental license in Massachusetts. This ensures the candidate has the necessary clinical knowledge to understand and evaluate a wide range of dental procedures and treatments. - State Licensure: The candidate must hold a current, unrestricted license to practice dentistry in Massachusetts. This is a standard requirement for any practicing dentist and demonstrates that they have met the state's requirements for professional practice. - Clinical Practice: Significant experience in a clinical setting as a practicing dentist is crucial particularly as a general dentist. This hands-on experience provides the practical knowledge needed to assess the appropriateness and necessity of care in real-world situations. A number of years of clinical practice would be expected. - Utilization Review or Insurance Experience: While not mandatory, prior experience in utilization review, quality assurance, or a similar role within the dental industry would be highly advantageous. This experience would indicate familiarity with the principles of managed care, clinical guidelines, the review process and comparable computer skills applications in Outlook, Word, and Excel. - Knowledge of Dental Coding and Terminology: A strong understanding of dental coding systems (such as CDT) and terminology is essential for accurately reviewing claims and treatment plans. In summary, the ideal candidate would be a licensed dentist with substantial clinical experience, and preferably, a background in the dental insurance industry with excellent communication skills. What You’ll Gain: Supplementation to Clinical Practice - Work-Life Balance: These positions typically offer a supplementation to your private practice schedule and the ability to use your clinical knowledge from practice in an administrative role to enhance the value of care to our members. - Reduced Physical Strain: An office/home based review role eliminates or reduces the physical stress often found in clinical dentistry. - The role provides an opportunity to affect dental care on a much larger scale than is possible when treating individual patients. - System-Level Influencing ensures that care is delivered to thousands of members in an efficient, effective, and necessary manner. - Focus on Evidence-Based Dentistry: The position is deeply rooted in the analytical application of the latest clinical guidelines and evidence, which can be educational about the science of dentistry. - New Skill Acquisition: It allows a clinician to develop valuable new skills in areas like data analysis, health policy, communication, and working within a corporate structure. In essence, this position appeals to experienced dentists who are looking for a new challenge, a better work-life balance, and a chance to apply their clinical knowledge to improve the healthcare system from a different vantage point. Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above Location HinghamTime Type Part time Hourly Range: $120.32 - $147.06 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 and 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 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 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" Page.

Business Analytics Advisor – Value-Based Care Analytics Do you love turning complex health data into insights that change how care is delivered? In this role, you will use advanced analytics to shape value-based care programs that improve affordability, quality, and outcomes. You will work with passionate experts across the organization to design solutions that help clinicians and partners make better decisions. We are an ambitious, collaborative team that values curiosity, compassion, and continuous learning. Responsibilities • Design and influence value-based payment programs by translating complex data into clear, actionable insights that support affordability and quality goals. • Lead advanced and exploratory analyses to uncover trends, root causes, and new opportunities within healthcare and specialty care data. • Apply strong statistical and analytic rigor to evaluate pilots and initiatives, supporting confident, data-driven decisions. • Build and maintain financial and analytic models that inform program design, forecasting, and performance reconciliation. • Partner closely with clinical, technical, and business teams to embed insights into tools and solutions used by providers and leaders. • Clearly communicate findings and recommendations to non-technical audiences to influence strategy and action. Qualifications Required • At least 5 years of experience in healthcare analytics, value-based care analytics, or related research roles. • Strong experience working with healthcare data such as medical claims, clinical, pharmacy, and eligibility data. • Advanced analytical skills using SQL and tools such as SAS, R, and/or Python. • Solid grounding in statistical methods including regression, confidence intervals, power analysis, and model validation. • Working knowledge of value-based care models such as ACOs, episodes, or bundled payments. • Ability to manage multiple priorities in a fast-paced, matrixed environment. • Clear and confident written and verbal communication skills. Preferred • Master’s degree or equivalent experience in statistics, data science, public health, health economics, or a related field. • Experience with medical economics or healthcare financial modeling. • Experience creating visualizations and storytelling through tools such as Tableau or Python-based libraries. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 107,700 - 179,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. - Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. - Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care - Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs - Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization - Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. - Typical office working environment with productivity and quality expectations. - Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. - Sedentary work involving periods of sitting, talking, listening. - Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. - Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. - Effective communication skills, both verbal and written Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET, CT zones Education Associates Degree required BSN preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $32.01 - $68.55 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/15/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• Execute enterprise pre-sales framework to engage customers, prospects, and partners via virtual and onsite meetings, drive the discovery process, lead product demonstrations, and identify areas where Workiva solutions align to address customer/prospect needs • Demonstrate expertise across all of Workiva’s domain areas - Financial Reporting, GRC, and Sustainability Reporting - developing working knowledge of industries, departments, and use cases where Workiva can have an impact • Partner with sales in territory planning in support of Workiva strategies and objectives • Conduct process assessments with customers, build Proof of Concepts to validate requirements, build and present partner specific business cases • Ensure customer success by working with implementation partners and Workiva Client Services team for smooth on-boarding and long term success • Assist in developing new use-cases or by using existing templates providing proof of our solution's impact and value proposition • May begin to deliver cross-domain coaching, training, or mentoring peers • Work with Sales, Product Marketing, Client Services, Scoping, and Customer Success to achieve team and company goals