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Utilization Management Supervisor (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as, regulatory...1 day ago on Professional Diversity NetworkTools -
Client Onboarding Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Client Onboarding Manager (OM) serves as the primary point of contact for new clients and provides them with an excellent experience throughout the onboarding lifecycle. The OM works directly with the Sales T...4 days ago on Professional Diversity NetworkTools -
Oncology Care Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Under minimal supervision, the Oncology Care Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Oncology Care Manager works closely with members and th...1 week ago on Professional Diversity NetworkTools -
Senior Risk Management Analyst (Hybrid) - Third Party Risk Management
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Senior Risk Management Analyst is responsible for supporting, facilitating, and training associates on operational risk programs designed to ensure the identification and mitigation of risks; management of co...2 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 interdisciplina...2 weeks ago on Professional Diversity NetworkTools -
Sales Enablement Data Analytics Manager (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The purpose of the Sales Enablement Manager and Network Data Analytics is to execute on business objectives with data and to ensure alignment with the vision of the Network Innovation and Strategy team (the busin...4 weeks ago on Professional Diversity NetworkTools -
Care Management Manager (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Reporting directly to the Director of Care Management/Inpatient Management, provides management and oversight, of Inpatient Clinical Navigators. The candidates must be familiar with MCG and the Concurrent Review ...4 weeks ago on Professional Diversity NetworkTools -
Utilization Management Coordinator I (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Supports the Inpatient Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care. Note:...4 weeks ago on Professional Diversity NetworkTools -
Care Manager (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications We are looking for an experienced professional to live and work remotely from within the greater Baltimore area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or ot...4 weeks ago on Professional Diversity NetworkTools -
Office of the CEO Operations Intern -Fall Recruitment (Hybrid) MD/DC/VA only
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Support the Office of the CEO in development of social determinants of health platform, including research, data analysis, document creation and project management. PRINCIPAL ACCOUNTABILITIES: Under the gene...4 weeks ago on Professional Diversity NetworkTools -
Senior Project Manager - Risk Adjustment Programs (Hybrid)
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 for Retrospective Risk Adjustment Activities for Chart Retrieval and Coding within Ca...4 weeks ago on Professional Diversity NetworkTools -
Venture Capital Manager (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Washington, DCResp & Qualifications PURPOSE: The Venture Capital Manager will play a key role in sourcing and evaluating new investment opportunities, executing on investment theses, and supporting our portfolio companies. ESSENTIAL FUNCTIONS: Seek ou...Over 4 weeks ago on Professional Diversity NetworkTools -
VP, Chief Ethics & Compliance Officer (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The VP, Ethics & Compliance oversees and manages the Company's Corporate Ethics & Compliance Program, serving as an independent and objective individual that reviews and evaluates compliance issues and concerns w...Over 4 weeks ago on Professional Diversity NetworkTools -
Pediatric Medical Director (Hybrid)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Medical Director oversees all activities of utilization review, care management and quality to determine the medical effectiveness of proposed treatments and approve care management plans - specifically with ...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
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