What is most important, with all Lithium-based chemistries, is to make sure the cells don't get over-discharged. If the cells in a pack become unbalanced, you very quickly get in a situation where the overall pack voltage is still higher than the LVC set in a controller, for instance, but you could have one, or more, cells that dump very quickly, as the pack gets close to depletion. That will kill cells. The problem is that you may not notice until it is too late. This is especially true for very high C-rated packs, because the pack feels just as strong 30 seconds from the end as it does in the beginning. If the cells are all balanced, they will all dump at once, so you will instantly feel the power drop. If just one, or two cells dump early, you might not notice soon enough.
The safest way to protect the packs is to use a LVC scheme that monitors each cell, and either cuts power, or tells the controller to cut the load, if any cell voltage drops too low. That way it doesn't matter if the cells are "balanced" or not, no cell can get discharged to the point of damage.
On the charging end, if the cells are all equally matched in capacity, internal resistance and thermal characteristics, a simple pack level CC/CV charger/supply can be used. Good quality packs will start out with cells that are very closely matched, but eventually they will drift apart, and end up with slightly different capacities. Unchecked, these differences can grow to the point that it can become a problem. RC-type balancers can bring the cells back to the same level, but most simply drag down the high cells to the level of the lowest. That's not necessarily the best way. The optimum way to charge a pack is to individually charge each cell. What that does is ensures that each cell can get a full charge, at its on pace. Most BMS boards basically work like individual chargers. Shunts let each channel bypass some current, once its cell is full, which lets the "slow" cells catch up. The newer RC balance-chargers basically do the same thing, which is to let each cell get full at its own pace.
-- Gary