39 information technology jobs found in Baltimore

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Your role involves managing the entire lifecycle of enterprise data products and services to align with company goals. You will lead the strategic direction of data products and coordinate teams of business leaders, data engineers, data architects, data analysts, and data scientists. As a Data Product Manager, you will establish and execute the data product operating model, define the vision and strategy for data products, implement product management processes, and produce roadmaps for high-quality, high-performing data products. You will also deliver data solutions that enhance the analytical experiences of CareFirsts customers and internal teams. You create value from the organization's data assets and enable internal/external analytics and insights. This includes developing strategies to achieve business outcomes, drive innovation, and ensure compliance with regulatory, legal, and ethical...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Vendor Management Manager is responsible for driving key business relationships with critical business partners, managing global partner issues, and working with internal teams such as Information Technology to ensure understanding of customer and business needs. This position will contribute to enhancing and optimizing the processes and workflows established between CareFirst and contracted vendors. In addition, the Vendor Management Manager will hold vendors accountable for contracted performance guarantees to ensure members receive the highest quality of service and ensure financial compliance to contracts. This role will manage a stable of vendors in the Information Technology space. ESSENTIAL FUNCTIONS: Responsible for overseeing the vendor management process including supervision and monitoring of Division vendor performance. Responsible for ensuring processes are in place to monitor vendor...

CareFirst BlueCross BlueShield Resp & 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 of computer systems, language, and/or equipment. Designs, codes, tests, develops, and documents application programs for computer systems. Works with end-users and project stakeholders to define system scope and objectives. Manages modifications to and maintenance of operational programs and procedures. Leads stakeholder and product owner meetings to define software requirements and creates highly complex systems. Acts as a mentor to junior engineers. ESSENTIAL FUNCTIONS: Lead a team of software engineers in the design, development, and implementation of multiple applications. Performs and leads the detail technical design, coding, code review and testing of new applications and enhancements of...

CareFirst BlueCross BlueShield Resp & Qualifications MD/DC/VA/DE Only CareFirsts Strategic Growth division is accepting internship applications for our internship program, spanning the companys marketing and communications, commercial saleas, government programs, federal employee program, and strategic enablement functions.Through this internship program you will join a small team of driven, optimistic individuals seeking to improve healthcare - for our members and the world at large. Combining diverse backgrounds, viewpoints, life experiences, and skillsets we seek to be a proactive agent of meaningful change. We are not just reimagining healthcare for the future, we are actively transforming the way it is delivered, supported, and experienced today.We are looking for like-minded individuals who both share our mission of improving healthcare and remain humbled (if undaunted) by scale of the challenge. Whether your passion lies in distilling insights from...

CareFirst BlueCross BlueShield Resp & Qualifications MD/DC/VA/DE Only CareFirsts Strategic Growth division is accepting internship applications for our Summer 2026 program, spanning the companys marketing and communications, commercial sales, government programs, federal employee program, and strategic enablement functions.Through this internship program you will join a small team of driven, optimistic individuals seeking to improve healthcare - for our members and the world at large. Combining diverse backgrounds, viewpoints, life experiences, and skillsets we seek to be a proactive agent of meaningful change. We are not just reimagining healthcare for the future, we are actively transforming the way it is delivered, supported, and experienced today.We are looking for like-minded individuals who both share our mission of improving healthcare and remain humbled (if undaunted) by scale of the challenge. Whether your passion lies in distilling insights from data,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Senior Business Analyst will have the responsibility to ensure that the Medicare Pharmacy business's need for changes to processes, policies and/or information systems are identified, understood, defined, documented and acted upon by eliciting, analyzing, documenting, validating, specifying and verifying the needs of business or user. The incumbent is accountable for the gathering and synthesizing of business requirements for moderate complexity software, systems, processes and/or services and translates them into specifications ensuring the business objectives are met. As the functional expert, the incumbent serves as a strategic conduit between the business area and the technical or software development team through which requirements flow. ESSENTIAL FUNCTIONS: Interprets Medicare Pharmacy business needs and issues by gathering, eliciting, creating, analyzing, documenting and validating the...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This role directly supports the Underwriting teams rating system by defining, designing, and developing system requirements. The position involves coordinating the design of subsystems, integrating total systems, and resolving program support deficiencies. The engineer will conduct independent technical investigations, perform elaborate data validation studies, and analyze system problems to develop effective innovation solutions. Responsibilities include designing, coding, testing, and documenting software applications. The role also requires gathering requirements, conducting advanced software analysis, and developing solutions. Additional duties involve integrating systems, designing architecture, and selecting suitable technologies and tools according to established project standards and procedures. This position collaborates closely with end-users and stakeholders to define system scope and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Senior Data Architect will support the design and implementation of enterprise data architecture across strategic initiatives. As a key leader in the organization, you will leverage your expertise in architecture, governance, integration, and analytics to enable data-driven decisions and regulatory compliance in a highly complex healthcare environment. This role requires effective leadership skills, technical expertise, and strategic thinking as it involves collaboration with cross-functional teams to ensure the integrity, scalability, and performance of our data platforms and analytics ecosystems. You will be responsible for the development of data models, data integration strategies, and data governance policies to implement industry best practices and advance the organizations modernization journey consistent with the enterprise data strategy. ESSENTIAL FUNCTIONS: Architecture and Design: Lead...

CareFirst BlueCross BlueShield Resp & Qualifications CANDIDATES MUST LIVE IN THE MD, DC, NORTHEN VA AREA IN ORDER TO TRAVEL INTO THE OFFICES AND FOR CLIENT MEETINGS AND STAFF MEETINGS. ACTIVE HEALTH AND LIFE LICENSE IS REQUIRED. PURPOSE: This position is a critical resource within the Account Management Team providing consultative expertise on benefits, products, and capabilities. Responsible for promoting new and existing products or services through the development and delivery of tactical marketing and communication initiatives. The Account Manager is directly responsible for aggressively growing group enrollment by marketing to the client's associate base. Builds and maintains effective long-term relationships and a level of satisfaction with key senior-level decision makers and influencers assigned to a group of strategic clients. Creates demand for the organization's products and services by successfully managing the internal and external client...

CareFirst BlueCross BlueShield Resp & 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 business needs for the domain into architectural solutions that meet performance, reliability and security expectations. Applies enterprise roadmaps, principles, standards, and practices to drive their domain strategies and execution. ESSENTIAL FUNCTIONS: Leads preparation of domain architecture viewpoints and models depicting current, target, and interim states. Use current state viewpoints to identify and analyze pain points and opportunities (PPOs). Lead advanced modeling and analysis to meet the strategic needs of the organization with respect to system, information, functional/non-functional needs, performance and security/regulatory requirements. Create and utilize architecture patterns...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE : The Clinical Medical Review Nurse handles day-to-day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication. The incumbent will handle post claim medical review for Commercial and Federal. This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. This role will also understand the merits of legal or accreditation actions. We are looking for an experienced RN to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Receives, researches, reviews and analyzes professional and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We are looking for an experienced Nurse Care Manager to work remotely from within the greater Baltimore, Maryland metropolitan area with both Adult and Pediatric members. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. Under minimal supervision, the Nurse Care Manager researches and analyzes the Adult and Pediatric member's medical and behavioral health needs and healthcare cost drivers. The Nurse Care Manager works closely with the member / members family and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to optimal health and cost-effective outcomes. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with member, family and providers to...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication. The incumbent will handle pre claim medical review for Commercial and Federal lines of business. This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. This role will also understand the merits of legal or accreditation actions. We are looking for an experienced RN to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Receives, researches, reviews and analyzes...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We are looking for an RN with significant clinical educator experience to work in a hybrid role from within the greater Baltimore/ Washington metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, trainings, provide training support for Care Management employees and/or other business-related activities. This role provides relevant new hire and supportive ongoing training/professional development which create and maintain a motivated, skilled and effective team through which organizational goals are achieved. In this position, the incumbent will be supporting all market segments of the Care Management Department providing training for Care Management employees related to new technology and documentation with our Guiding Care platform, the Care Management process, and interventions to drive outcomes for our members. Demonstrated experience with...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We are looking for Medical Management Coordinator to 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. In this position, you will have direct and measurable impact on the lives of CareFirst members that are part of the Maryland Medicaid line of business. The Medical Management Coordinator plays a critical role in ensuring members receive timely, appropriate, and coordinated care. This position supports the clinical teams and Care Managers by addressing non-clinical tasks related to care coordination enabling clinical staff to perform at the top of their license. This position includes frequent telephone and email communications with members, providers, and interdisciplinary care teams. Included in these communications are monitoring...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Sr. Business Consultant ACA Individual serves as a strategic subject-matter expert responsible for designing, launching, and executing initiatives that advance organizational goals within the evolving healthcare landscape. This role is integral to driving ACA market growth by: Defining and implementing the ACA Operating Model and Playbook Partnering across matrixed teams to lead initiatives with the goal of increasing CareFirst market share, improving member/broker experience, and strengthening ACA Individual performance. Developing ACA dashboards to strengthen enterprise alignment with key performance indicators (KPIs) ESSENTIAL FUNCTIONS: Lead the development of the ACA Individual Operating Model and Playbook, ensuring clear end-to-end ownership of all ACA processes and alignment with defined KPIs, strategic priorities, and performance targets. Proactively identify, evaluate, and execute...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Business Consultant ACA Individual provides strategic, analytical, and operational expertise to support the design, launch, and execution of initiatives that strengthen ACA Individual market performance. This role contributes directly to CareFirsts ACA growth strategy by delivering insights, driving operational efficiencies, and supporting cross-functional alignment in a rapidly evolving healthcare environment. ESSENTIAL FUNCTIONS: Support the development of ACA dashboards in partnership with the external analytics vendor to segment member populations, identify cost-saving opportunities, and drive performance improvement. Leverage analytics to inform ACA marketing strategies by identifying priority populations and geographic segments. Collaborate with risk adjustment, care management, quality, and network teams to i improve coding performance and overall ACA member outcomes. Conduct competitive...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: a { text-decoration: none; color: #464feb;}tr th, tr td { border: 1px solid #e6e6e6;}tr th { background-color: #f5f5f5;} This role supports the Dual Special Needs Population (DSNP) in Maryland. Under minimal supervision, the Care Manager conducts thorough research and analysis of members medical and behavioral health needs, along with the key drivers influencing healthcare utilization and costs. The Care Manager partners closely with members and the interdisciplinary care team to develop and implement person-centered plans of care that promote a positive member experience, improved health outcomes, and costeffective service delivery. We are seeking a bilingual Care Manager to enhance communication, cultural responsiveness, and engagement with our diverse DSNP member population. This position is remote, with the expectation that the selected candidate resides within the greater Baltimore metropolitan area....

CareFirst BlueCross BlueShield Resp & Qualifications CareFirst runs a year-round internship program. The ideal candidate is someone who can work throughout the year 15-20 hours per week. PURPOSE: The organizational function of an Enterprise Architecture (EA) team is to ensure that business strategy, operating model, capabilities, information, and technology investments are intentionally aligned so the enterprise delivers value faster, with less redundancy, lower risk, and clearer accountability. Interns assist the company with tasks set out by various teams, such as research, data capturing, and working closely with different team members to learn more about the company. As an intern for the Enterprise Architecture team, the individual will play a key role in helping us design and launch procedures that will help maintain this reliability and consistency of enterprise portfolio data. This internship will also assist with procedural mechanics of Enterprise...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Onsite Clinical Navigator (RN) embedded at a partnering hospital will conduct concurrent review of inpatient level of care, managing 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, the Onsite Clinical Navigator will leverage proficiency in established MCG, in addition to administrative/regulatory considerations, to determine medical necessity, appropriate level(s) of care and case management to engage members/enrollees, their families and other support systems in discharge planning. The role will function as a liaison working onsite at the assigned hospital up to 5 days per week and occasional weekend work may also be required, both at management's sole discretion. Such work will be conducted with the hospital care team including case managers, social workers and discharge planners...