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Functional Analyst I (Hybrid)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Provides analysis and reporting to enable the effective credentialing of institutional and ancillary providers by obtaining provider related data; analyzing gaps in provider records; designing solutions; carrying...2 weeks ago on Professional Diversity NetworkTools -
Customer Service Advocate I- MD Aug (Hybrid)
Customer Service · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides i...2 weeks ago on Professional Diversity NetworkTools -
Executive Assistant I (Hybrid)
Admin/Clerical · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Provides administrative support for a Vice President / SVP. Performs advanced, diversified and confidential duties that may be administrative in nature or project based. Work requires broad and comprehensive exp...2 weeks 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 -
Clinical Navigator (Remote)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both care management and utilization management includin...2 weeks ago on Professional Diversity NetworkTools -
Medicaid Quality Analyst (Hybrid)
Quality Assurance · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Medicaid Quality Analyst is responsible for defining, measuring, analyzing, and evaluating population health, while prioritizing, developing, and operationalizing innovative initiatives to improve HEDIS measu...2 weeks ago on Professional Diversity NetworkTools -
West Baltimore Community Health Navigator (Hybrid)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications APPLICANT MUST RESIDE IN ONE OF THE FOLLOWING ZIP CODES: 21215, 21216, 21217 PURPOSE: This position will support the Maryland government programs division, working as a bridge between the member, clinical and administ...3 weeks ago on Professional Diversity NetworkTools -
Senior Quality Analyst (Hybrid)
Quality Assurance · Carefirst Bluecross Blueshield · Baltimore, MDSalary Range Disclaimer PURPOSE: Plans, organizes, and manages large scale or complex projects for successful delivery of RAF and Risk Revenue/HCC projections for multiple LOB's. Initiates, engages, and motivates cross-functional teams to deli...3 weeks ago on Professional Diversity NetworkTools -
Virtual Family Physician - CloseKnit (Remote)
Healthcare · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: We are currently hiring physicians to join our CloseKnit team to deliver care. CloseKnit is a virtual first advanced primary care practice looking for an experience person interested in innovating in the practic...3 weeks ago on Professional Diversity NetworkTools -
Medical Assistant - CloseKnit (Hybrid)
Healthcare · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: Provide safe patient care & clinical support. The Medical Assistant maintains efficient patient flow, supports an environment of patient safety and satisfaction, supports high-quality care delivery and demonstrat...3 weeks ago on Professional Diversity NetworkTools -
Senior Embedded Compliance Analyst (Remote)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: This role will support the division and corporate compliance in the delivery and performance of a compliance program to help ensure compliance and alignment with Federal, State, and related regulatory statutes, a...4 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 -
Vendor Relations Specialist (Hybrid)
Everything Else · Carefirst Bluecross Blueshield · Baltimore, MDResp & Qualifications PURPOSE: The Vendor Relations Specialist is responsible for corporate vendor management assigned to the IT department and focuses on developing and managing business partnerships. This role provides support for business o...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