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Commercial Markets Account Consultant III - 300-999 markets (Remote MD/DC/VA)
Consulting · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: This position is responsible for renewing/growing a commercial markets (fully insured & self insured) books of business which includes more complex accounts with indemnity and managed care medical products, ancil...3 weeks ago on Professional Diversity NetworkTools -
Medical Review & Appeals Director (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Ensures alignment with the overall Corporate Strategic Plan through direction of the Clinical Medical Claims Review, Medical Underwriting, Medical Policy, Clinical Appeals and Analysis programs and Quality of Car...3 weeks ago on Professional Diversity NetworkTools -
Systems Engineering Supervisor (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications PURPOSE: Responsible for planning, supervising, assigning, leading, and monitoring work of the department responsible for the planning and engineering of the organization's infrastructure. Ensures that hardware and/or sof...3 weeks ago on Professional Diversity NetworkTools -
HR M&A Senior Project Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Plans, organizes, and manages large scale or complex projects for successful delivery of objectives, on time and within budget. Initiates, engages, and motivates cross-functional teams to deliver results. Identif...4 weeks ago on Professional Diversity NetworkTools -
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, ...4 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...4 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...4 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...4 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...4 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...4 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...Over 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 ...Over 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...Over 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...Over 4 weeks ago on Professional Diversity NetworkTools -
Lead Software Engineer, (Remote)
Computer/Software · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications PURPOSE: Performs complex analysis, design, development, automated unit and integration testing, and debugging of computer software ranging from operating system architecture integration and software design to selection ...Over 4 weeks ago on Professional Diversity NetworkTools