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Quality Assurance Specialist I (Remote)
Quality Assurance · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Quality Assurance Specialist I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines. Fairly and consistently reviews team interactions...1 hour ago on Professional Diversity NetworkTools -
Clinical Appeals Nurse (Remote)
Healthcare · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills...1 hour ago on Professional Diversity NetworkTools -
Care Management Coordinator I (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Supports Care Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to care coordination and quality of care. This position will support our Medicaid Care Mana...1 hour ago on Professional Diversity NetworkTools -
Quality Assurance Specialist I (Remote)
Quality Assurance · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications PURPOSE: The Specialist, Quality Assurance I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines. Fairly and consistently reviews team interaction...1 day ago on Professional Diversity NetworkTools -
Scrum Master (Remote)
Everything Else · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications PURPOSE: Leads a cross functional team, guiding them on how to use Agile, Scrum and Lean values/practices through servant leadership. Creates and nurtures a culture of continuous learning, growth mindset and agile maturit...1 day 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 ...1 day ago on Professional Diversity NetworkTools -
Manager, Specialty Pharmacy Financial Value & Solutions (Remote)
Management & Exec · Carefirst Bluecross Blueshield · Owings Mills, MDResp & Qualifications Although this position is REMOTE, candidates MUST live in the MD, DC, VA , PA, DE and surrounding areas in order to travel to offices and client meetings. PURPOSE: The Manager, Specialty Pharmacy Financial Value & Sol...3 days ago on Professional Diversity NetworkTools -
Broker Relations Advisor (Remote)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications 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 market...TopUSAJobs.com ·3 days ago on TopUSAJobsTools -
Cybersecurity Engineering Manager (Remote)
Engineering · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: You will be responsible for managing CareFirsts Cybersecurity engineering team, with a strong emphasis on cloud, identity, and infrastructure security. You will execute and implement the CareFirst Cybersecurity ...4 days ago on Professional Diversity NetworkTools -
Senior Data Market-Facing Analytics Analyst (Hybrid)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Sr. Data Analyst will be responsible for driving strategy and delivery of two key analytic tools that will be built using provider and claims data. The Analyst will sit on the Value and Sales Enablement team ...1 week ago on Professional Diversity NetworkTools -
Social Worker - LCSW (Remote)
Social Services · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Social Worker (SW) may support the Care Managers, Supervisors, Manager, and Director of Care Management for the FEP Population. They are to ensure available resources are being used in a timely and cost-effec...2 weeks ago on Professional Diversity NetworkTools -
Principal Cloud Architect (Remote)
Architect/Design · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Drives enterprise optimization by introducing capabilities (inclusive of all functions) for their domain of responsibility utilizing in-depth knowledge and expert skills to advance domain strategies. Translates b...2 weeks ago on Professional Diversity NetworkTools -
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...2 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...2 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...2 weeks ago on Professional Diversity NetworkTools