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SIU Coordinator (Hybrid)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Triage and develops case leads for the department, using various data sources and employing statistical analysis and reporting skills. ESSENTIAL FUNCTIONS: Reactively perform triage on calls, tips, alerts, ...3 weeks ago on Professional Diversity NetworkTools -
Document Automation Center Solution Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: We are looking for a Solution Manager for Document Automation in our Card to Care Value Stream. These systems deliver bulk document generation, omnichannel transmission, archiving, and desktop audits across CareF...3 weeks ago on Professional Diversity NetworkTools -
Senior Underwriter - Pharmacy (Remote)
Insurance · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Responsible for evaluating applicant situation and circumstances; studying rate tables, codes, computer records and references, and other resources; calculating premium rates; negotiating reinsurance terms; descr...3 weeks ago on Professional Diversity NetworkTools -
Nurse Practitioner - CloseKnit (Remote)
Healthcare · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: We are currently hiring a Nurse Practitioner to join our CloseKnit team to deliver virtual care. CloseKnit is a virtual first advanced primary care practice looking for an experience person interested in innovati...3 weeks ago on Professional Diversity NetworkTools -
Oncology Care Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Under minimal supervision, the Oncology Commercial Care Manager researches and analyzes an Oncology member's medical and behavioral health needs and healthcare cost drivers. The Oncology Care Manager works closel...3 weeks ago on Professional Diversity NetworkTools -
Associate Financial Analyst (Hybrid)
Accounting/Finance · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Responsible for collecting, analyzing, and interpreting financial data as well as preparing reports, models, presentations and recommendations for leaders of a business or clients. Interfaces regularly with proje...3 weeks ago on Professional Diversity NetworkTools -
Pediatric Care Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Under minimal supervision, the Pediatric Commercial Care Manager researches and analyzes a Pediatric member's medical and behavioral health needs and healthcare cost drivers. The Pediatric Care Manager works clos...3 weeks ago on Professional Diversity NetworkTools -
Senior Stars & Risk Adjustments Analyst (Remote)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Supports Risk Adjustment & Stars organization to optimize Risk Adjustment revenue and coding accuracy through data-driven approach to closing gaps and risks in coding and care delivery across Medicare & Medicaid ...3 weeks ago on Professional Diversity NetworkTools -
Senior IT Project Manager (Remote)
IT · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications As a Project Manager on the Mandates Implementation team within the ePMO, you will be responsible for managing the implementation of local, state, and federal legislation, as well as Blue Cross and Blue Shield Association (...3 weeks ago on Professional Diversity NetworkTools -
Custom Provider Networks Program Manager (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Manages end-to-end oversight of custom (ie.Domestic) network development in support of national account sales. The Program Manager will work across two high profile divisions driving membership growth through net...4 weeks ago on Professional Diversity NetworkTools -
Care Management Supervisor (MD/ DC/ Northern VA) (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Care Management Supervisor supervises, directs and coordinates the activities of Care Managers. Develops and reviews Care Management standards, program criteria, policies, and procedures to ensure quality of ...4 weeks ago on Professional Diversity NetworkTools -
Behavioral Health Care Management Manager (Hybrid)
Healthcare · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Manager supports the Director of Behavioral Health Services and the CareFirst Mission of providing affordable health insurance and accessible health care to all. The incumbent builds an effective, efficient w...4 weeks ago on Professional Diversity NetworkTools -
Product Lifecycle Manager (Hybrid MD/DC/VA)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Manages product lifecycle for products in a product family. Assess product performance, forecast sales in line with sales objectives. Lead product pricing, packaging, positioning and P&L. Conduct market assessmen...4 weeks ago on Professional Diversity NetworkTools -
Director, Pharmacy Government Programs (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications This position is HYBRID and requires frequent travel into the Maryland office; therefore, candidates must live within driving distance. PURPOSE: Director, Pharmacy Government Programs is responsible for implementing th...4 weeks ago on Professional Diversity NetworkTools -
Care Manager (MD/DC/Northern VA) (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Under minimal supervision, the Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager works closely with members and the interdisciplinar...4 weeks ago on Professional Diversity NetworkTools