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📑 BlueCross BlueShield of North Carolina Senior Consultant, Enterprise Strategy Remote , North Carolina Apply Now Job DescriptionAs an Enterprise Strategy Senior Consultant, you’ll develop new and groundbreaking strategies to further our purpose – to make health care better for all – by solving complex challenges that transform health ...

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📑 BlueCross BlueShield of Tennessee Lead Medical Director Chattanooga , Tennessee Apply Now Provides clinical leadership and serves as an internal medical consultant to various divisions and committees to support the development, implementation and monitoring of medical management and quality improvement activities.Job Description:Job ...

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📑 The incumbent is responsible for the retention of pharmacy membership by using medical, pharmacy, and economic data to drive the development, implementation, and maintenance of drug solutions that align with the enterprise strategy and meet the desired outcomes of customers.Job Description:Job ResponsibilitiesUtilize clinical information and analyt ...

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📑 Description : Job Qualifications Education Active college student (in an accredited college or university) who has completed a minimum of two years of college are eligible. Recent college graduates and students enrolled in a Masters or Doctoral program (in an accredited coll ...

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📑 Reaches out to members, providers and pharmacies for the purpose of improving members' health and to improve HEDIS metrics .Job Description:Job ResponsibilitiesReviewing, updating, maintaining and monitoring pharmacy information disseminated to external and internal customers (as necessary).Conducting outbound educational telephone calls regarding ...

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📑 BlueCross BlueShield of Tennessee Senior Cloud Security Engineer Chattanooga , Tennessee Apply Now This position is responsible for securing BCBST technology assets and the environments in which those assets function and exist. This role will support the execution of specific cyber security projects as assigned. Responsibilities inc ...

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📑 Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Ca ...

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📑 This Position, a physician properly credentialed as a Psychiatrist, is responsible for the delivery of professional and competent psychiatric care (in person and/or by telemedicine) to a full caseload (prorated based on %FTE), to individuals in need of crisis services and/or general psychiatric care. Additional duties may include provision of servi ...

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📑 Home / Job Search / Senior Business Consultant - Medicaid Growth (Remote) Senior Business Consultant - Medicaid Growth (Remote) Job ID: 19485 Job Function: Strategic Planning Location: Washington, DC, United States Campus: DC-Washington-Union Center Plaza The Sr. Business Consultant for Medicaid Growth provides expertise in tailored, strateg ...

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📑 Home / Job Search / Senior Business Consultant - Medicaid Growth (Remote) Senior Business Consultant - Medicaid Growth (Remote) The Sr. Business Consultant for Medicaid Growth provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives for CareFirst BlueCross BlueShield Medic ...

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📑 Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s ...

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📑 Description Logistics: This position is full-time (40-hours/week) Monday-Friday working a flexible eight-hour schedule between the hours of 7:00am - 6:30pm remote within the United States. What You’ll Do: Independently and objectively helps plan and execute audits in a ...

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📑 Description Logistics: This is a full-time position working (40-hours/week) Monday-Friday 8:00am – 5:00pm working remotely in the US or on-site in Birmingham, AL. What You’ll Do: Works with provider representatives to resolve appeal cases, including writing position papers and ...

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📑 Description Receive specific case proposal requests and review for completeness, reject when necessary and gather missing information. Underwrite cases including setting rates, aggregate factors, and coverage terms/conditions according to negotiated MGU agreements with insurers/reinsurers. Design sto ...

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📑 Description Logistics: This is a full-time position working (40-hours/week) Monday-Friday 8:00am – 5:00pm working remotely in the US or on-site in Birmingham, AL. What You’ll Do: Works with provider representatives to resolve appeal cases, including writing position papers and ...

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📑 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of ...

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📑 Location: Owings Mills, MD, United States This position oversees and directs the work of analysts in a supervisory capacity. This position is responsible for implementing departmental strategy and policies in order to meet team goals, as well as making recommendations to Actuarial management where appropriate. Essential Functions:Responsible for ...

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📑 Campus: DC-Washington-Union Center Plaza PURPOSE: The Venture Capital Analyst sources and evaluates new investment opportunities, executing on investment theses, and supporting our portfolio companies. Additionally, the Venture Capital Analyst understands how innovative technologies and business models can transform healthcare and improve the qual ...

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📑 Home / Job Search / Learning & Development Associate Specialist (Hybrid) Learning & Development Associate Specialist (Hybrid) Job ID: 19429 Job Function: Human Resources Location: Owings Mills, MD, United States PURPOSE: Facilitates training programs to ensure that employees are equipped with the right skills, knowledge/abilities to perform th ...

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📑 PURPOSE: Supports Benefit Contract Management (BCM) by assisting or performing accountabilities/tasks that include but are not limited to: revising/updating contract forms and templates; reviewing contract forms, templates and related marketing materials; preparing electronic filings via SERFF; tracking status of filings; creating sample contracts; ...

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📑 About the job**No experience necessary and fully remote work available****This is a 1099 (commission) direct pay from the carrier opportunity**Our mission at LifeSmart Senior Services is to prioritize the families we protect and the families of our brokers.We specialize in Medicare (Medicare Supplements, Medicare Advantage, Medicare Part D), Hospit ...

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📑 About the job**No experience necessary and fully remote work available****This is a 1099 (commission) direct pay from the carrier opportunity**Our mission at LifeSmart Senior Services is to prioritize the families we protect and the families of our brokers.We specialize in Medicare (Medicare Supplements, Medicare Advantage, Medicare Part D), Hospit ...

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📑 Home / Job Search / Vice President, Product Management & Development (Hybrid) Vice President, Product Management & Development (Hybrid)PURPOSE: The Vice President of Product Management & Developmentis responsible for a full spectrum of product disciplines. This role will lead and drive the management, development and evaluation of the comprehens ...

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📑 Home / Job Search / Business Consultant- Clinical Technology Ecosystem (Remote) Business Consultant- Clinical Technology Ecosystem (Remote)PURPOSE: The Business Consultant provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives in the changing healthcare environment. This ...

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📑 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 closely with the Oncology members family and the interdisciplinary care team to ensure members have an effective plan of care and posit ...

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📑 Home / Job Search / Client Success Director - Labor Markets (Hybrid MD/DC/VA) Client Success Director - Labor Markets (Hybrid MD/DC/VA) Job ID: 19704 Job Function: Sales & Account Management PURPOSE: The Client Success Director is a consultative leader within sales team who establishes and drives mutually beneficial relationships with key clien ...

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📑 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 populations. Responsible for developing performance monitoring reports and analytics related to Risk Adjustment & Stars programs ...

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📑 Home / Job Search / Sales Consultant III - New Business Development (Remote) Sales Consultant III - New Business Development (Remote) Job ID: 19614 Job Function: Sales & Account Management CANDIDATES MUST LIVE IN THE DC/VA AREA IN ORDER TO TRAVEL FREQUENTLY INTO THE OFFICES AND TO ATTEND CLIENT MEETINGS. PURPOSE: This position is responsib ...

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📑 Campus: DC-Washington-Union Center Plaza PURPOSE: Facilitates CareFirst's long-term community investments to advance the company's mission to pursue health equity by addressing social determinants of health. Strategically leverages CareFirst's assets, authentically engaging communities, and a diverse set of stakeholders to measurably improve the h ...

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📑 Campus: DC-Washington-Union Center Plaza PURPOSE: The External Affairs Manager is responsible for developing and enhancing relationships with government officials in their respective jurisdiction(s) to include five counties in Maryland- Frederick County, Montgomery County, Prince Georges County, Calvert County, Charles County, and St. Marys County ...

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📑 Care Manager (MD/DC/Northern VA) (Remote)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 interdisciplinary care team to ensure members have an effective plan of care and positive member experie ...

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📑 Disaster Recovery Engineering Manager (Remote) Job ID: 19587 Job Function: Information Technology Location: Columbia, MD, United States Campus: MD-Columbia-Columbia Data Center PURPOSE: CareFirst is undertaking an IT Systems Modernization Program that involves a migration to cloud, upgrades to modern infrastructure and consolidation of applicati ...

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📑 PURPOSE: Serves as the creative lead for the enterprise, bringing creative concepts to life through the design, development and publishing of public-facing websites, email, social media, online ads, other digital content, marketing assets and communications. The role manages a multi-disciplinary team of graphic designers, digital designers, web edi ...

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📑 PURPOSE: Senior Contract Specialist works closely with Corporate Governance (Legal), Government Affairs, Product, Marketing, Mandates, Health Services, and Strategy and Transformation providing input to company, divisional and departmental goals and initiatives, to ensure contract form compliance, recommend and implement improvements. This position ...

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📑 Job Function: Sales & Account Management Candidates MUST live in the MD, DC, VA area in order to travel into the offices and for client meetings. PURPOSE: The Broker Relations Advisor's primary responsibility is to bring the value of CareFirst to the marketplace by engaging and working with CareFirst's distribution channel (brokers). Under the di ...

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📑 Home / Job Search / Product Lifecycle Manager (Non-Technical) - Hybrid Product Lifecycle Manager (Non-Technical) - Hybrid PURPOSE: Manages product lifecycle (strategy, design, execution, and optimization) for products and plans in the Medicare, Medicaid, and Federal Employee Health Benefits categories. Leads the team in assessing product p ...

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📑 We are looking for an experienced professional to live and work remotely from within the greater Baltimore/Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. Ability to speak fluently in Spanish is a huge plus! PURPOSE: Un ...

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📑 Director, Pharmacy Government Programs (Hybrid)PURPOSE: Director, Pharmacy Government Programs is responsible for implementing the organization's pharmacy vision and strategic plan for government programs (Medicare and Medicaid). This role has oversight of pharmacy staff and develops and maintains collaborative relationships with clinical, administ ...

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📑 Systems Engineering Supervisor (In Office) PURPOSE: Audio-Visual Support Supervisor to work in multiple CareFirst office locations and outside event space. The Supervisor will develop, implement, and promote standards, systems, and resources for supporting CareFirst AV team and users in conjunction with the Conference Services, Facilities and Te ...

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📑 Home / Job Search / Senior Risk Management Analyst - Third Party Risk Management (Hybrid) Senior Risk Management Analyst - Third Party Risk Management (Hybrid) PURPOSE: The Senior Risk Management Analyst is responsible for supporting, facilitating, and training associates on third-party risk programs designed to ensure the identification and mi ...

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📑 Campus: DC-Washington-Union Center Plaza PURPOSE: To ensure the organization's data remains protected from inappropriate access, disclosure and/or damage. To advocate for and execute the processes and practices of the Cybersecurity team while supporting business and customer needs. ESSENTIAL FUNCTIONS: Suggests improvement initiatives through ...

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📑 Home / Job Search / Market Research Consultant - Health Services (Hybrid) Market Research Consultant - Health Services (Hybrid) Job ID: 19531 Job Function: Marketing Location: Washington, DC, United States Campus: DC-Washington-Union Center Plaza Champions customer centricity throughout the Company and adds value to the business by helping s ...

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📑 PURPOSE: We are seeking an experienced, high energy, driven, servant leader to lead our Platform Solutions organization. The Director, Platform Solutions will focus on cloud & infrastructure engineering, site reliability engineering (SRE), process improvement, technical disaster recovery planning support and operational system hardening. This sen ...

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📑 ** Account Sales Consultant III - 003211****Job Category****:** Non Manager **Requisition Number****:** ACCOU006889 Showing 1 location **Job Details****Description**Summary Under the supervision of the local Manager, Sales/Regional Sales Director, and having attained an extensive and thorough knowledge of all contracts, enro ...

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📑 About the job**No experience necessary and fully remote work available****This is a 1099 (commission) direct pay from the carrier opportunity**LifeSmart Senior Services, is an Integrity Marketing Group company. The Integrity Marketing Group is one of the nation’s largest independent distributors of health insurance products. Our mission at LifeSmar ...

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📑 Resp & QualificationsPURPOSE:The Sr. Business Consultant for Medicaid Growth provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives for CareFirst BlueCross BlueShield Medicaid line of business. This is an exciting opportunity to join a growing team who is passionate about m ...

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📑 Resp & QualificationsPURPOSE:The Sr. Business Consultant for Medicaid Growth provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives for CareFirst BlueCross BlueShield Medicaid line of business. This is an exciting opportunity to join a growing team who is passionate about m ...

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📑 Resp & Qualifications PURPOSE: The Sr. Business Consultant for Medicaid Growth provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives for CareFirst BlueCross BlueShield Medicaid line of business. This is an exciting opportunity to join a growing team who is passionate ab ...

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📑 This position performs professional nursing duties as assigned in a 10 bed, 48-hour behavioral health care unit. This Registered Nurse (RN) must possess strong knowledge of the principles, methods, and practices of working with individuals with psychiatric and mental health and or medical concerns.Responsibilities include nursing triage and assessm ...

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📑 OPEN POSITION:Physician - EndocrinologistSCHEDULE:- Full-Time- Monday through Friday- 8:00am to 5:00pm- Some Flexibility Offered- No Nights or Weekends- Minimal On-CallCOMPENSATION:- Graduated Compensation Model, based on tenure- $180,000 to $200,000 Guaranteed Salary, first year of employment- $250,000 to $350,000 Annual Income (year 2+), based on ...

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