26 program coordinator jobs found

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Business Analyst will have the responsibility to ensure that the 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 assists in the gathering and synthesizing of business requirements for low 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 the conduit between the business area and the technical or software development team through which requirements flow. ESSENTIAL FUNCTIONS: Interpret business needs and issues by gathering, eliciting, analyzing, documenting and validating the Business area?s user and technical (functional/non-functional) requirements....

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Regulatory Compliance Analyst will conduct independent analysis for complicated, high level regulatory inquiries and provide interpretation of regulatory rules and guidelines to demonstrate compliance with state and federal requirements. ESSENTIAL FUNCTIONS: Provide interpretation of regulations and regulatory rules/guidelines to ensure compliance with state and federal requirements. Review and analyze all data received to generate comprehensive written responses to the originating party. Strategize with Legal and Compliance as needed to identify the best response to the complaint. Maintain positive, responsive, respectful relationships with all regulators. Occasional external contact with Regulatory Agency Investigators. Identifies potential volatile activity by gathering and analyzing regulated organizational data. Research, resolve and respond to written and telephone inquiries received....

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Senior Business Analyst will have the responsibility to ensure that the 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 business needs and issues by gathering, eliciting, creating, analyzing, documenting and validating the Business areas user and/or technical...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The purpose of the Lead Data Analyst, Pharmacy is to execute pharmacy business objectives with data and ensure alignment with the goals of Pharmacy and the overall vision of the company. The individual leads the design, development, and delivery of analytics solutions by defining data requirements, analytical approaches, reporting processes, and governance practices needed to address current and future analytics needs of the pharmacy business. This role provides thought leadership and serves as a subject matter expert (SME) in selecting and applying appropriate analytical methods and in translating complex analyses into clear, actionable insights for pharmacy SMEs, business leaders, and executive audiences. ESSENTIAL FUNCTIONS: Develop and maintain recurring reporting, executive-ready dashboards, and data presentations that support day-to-day pharmacy operations, key reporting milestones, and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This RN position supports line of business. Under minimal supervision, the Care Manager researches and analyzes members' 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 experience that leads to optimal health and cost-effective outcomes. We are looking for an experienced clinician 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: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with members, family and providers to develop a comprehensive plan of care to address the member's needs at...

CareFirst BlueCross BlueShield Resp & 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 experience, skills and a thorough knowledge of organization policies and practices. Prepares correspondence, reports, presentations, etc. Sets up meetings and may act as proxy for superior. Requires sufficient skills to communicate effectively with peers and senior level management staff. Performs complex tasks requiring the consideration of multiple variables to determine proper course of action. While tasks are complex, most decision-making can be made within pre-determined approaches. May lead and provide functional guidance to lower level support employees. Works under general guidance/supervision. ESSENTIAL FUNCTIONS: Provides day-to-day administrative support (such as calendar maintenance,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Manager, Technology Operations Center (TOC) is a hands-on technical leader responsible for operating and evolving a modern, cloud-first Technology Operations Center. This role owns Major Incident Management, Event Management, and enterprise monitoring and observability, supporting a large-scale Azure-based application and infrastructure ecosystem. The role is deeply aligned to ITIL v4 processes, Site Reliability Engineering (SRE) principles, and AI-driven operations, leveraging Dynatrace as the primary observability platform and ServiceNow as the ITSM system of record. The successful candidate will drive measurable improvements in service reliability, incident response, and operational automation while ensuring technology services meet the high availability standards required in health care insurance. ESSENTIAL FUNCTIONS: Lead the technical and operational execution of the Technology Operations...

CareFirst BlueCross BlueShield Resp & Qualifications We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. PURPOSE: This role will lead, guide, strategize and manage negotiations for provider-specific institutional, ancillary, and professional contracts. Key responsibilities include negotiating contract terms in accordance with regulatory requirements, analyzing financial data to evaluate implications across various business lines, while ensuring compliance with company policies and procedures, and coordinating with the Payment Transformation team to transition fee-for-service arrangements to value-based care. This role will also oversee complex projects related to provider...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Marketing Technology & Insights Intern will support Marketing Technology (MarTech) initiatives focused on data strategy and platform enablement, while also assisting with enterprise survey research efforts led by the Insights team. Approximately 75% of this role will focus on MarTech responsibilities, including marketing systems, data flows, and platform evaluation. The remaining 25% will support survey research initiatives that inform marketing, experience, and business decisions across audiences. This is a year-round internship opportunity. We are looking for students who can commit to our work up to 15-20 hours per week during the academic year in the Fall/Spring and 35-40 hours per week during the Summer. The start date for the internship will be May 18th or June 1st. ESSENTIAL FUNCTIONS: 75% Marketing Technology (Data Strategy & Platform Enablement) Support marketing data...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Digital Marketing Project Manager Provider & Member Engagement leads the planning, execution, and optimization of digital communications across email, web, SMS, and mobile-first channels. This role manages campaigns that support both member and provider audiences, ensuring timely, compliant, and engaging communications that align with organizational goals and customer experience strategies. ESSENTIAL FUNCTIONS: Manage end-to-end project delivery for mobile engagement/SMS, email, and web campaigns targeting both member and provider audiences. Develop project plans, timelines, budgets, and resource allocations for lifecycle, operational, and promotional communications. Coordinate with cross-functional teams including marketing, provider relations, business areas, clinical teams, compliance, analytics, product, and IT. Oversee campaign workflows from intake and strategy through build,...

CareFirst BlueCross BlueShield Resp & Qualifications MD-DC-Northern VA 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 experience that leads to optimal health and cost-effective outcomes. This position will support the Federal Employee Program line of business. We are looking for an experienced professional to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with members, family and providers...

CareFirst BlueCross BlueShield Resp & Qualifications Maryland/ DC/ Northern VA 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 experience that leads to optimal health and cost-effective outcomes. This position will support the Federal Employee Program line of business. We are looking for an experienced clinician to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. 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: 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 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: 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: 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 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...

CareFirst BlueCross BlueShield Resp & Qualifications (Maryland-DC-Northern VA) 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 experience that leads to optimal health and cost-effective outcomes. We are looking for an experienced professional to work remotely from within the greater Baltimore/Washington DC metropolitan areas. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Identifies members with acute/complex medical and/or behavioral health conditions. Engages onsite and/or telephonically with member, family and providers to develop a comprehensive plan of care to address the members needs at...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Director of Accounting is considered part of the Finance & Accounting's Leadership Team and an expert in their field. The position will supervise one or more departments in their functional area and is expected to demonstrate all the leadership behaviors set forth by the Company in the manner in which they lead. Incumbent is responsible for maintaining strong financial internal controls and drive decisions that impact the Finance & Accounting organization. Additionally, this position is considered a visible resource across the enterprise, including members of the executive leadership team. ESSENTIAL FUNCTIONS: Direct the management of the monthly closing of the financial systems, recording of accruals and reserves as appropriate, ensuring that all activities are executed in a timely manner and in accordance with associated accounting policies, procedures and guidelines. This function includes...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Paralegal III position is an advanced position for an experienced paralegal with subject matter expertise in a designated specialty area of the law, such as litigation (plaintiff and/or defense), with a focus on regulatory, compliance and employment law, providing advanced support to the attorneys in the organization and to other Divisions or Departments as directed by counsel. ESSENTIAL FUNCTIONS: Work in Specialized Area of Expertise: Proactively, monitor and manage compliance with statutory and regulatory requirements in the area of expertise, including investigating and researching complex legal matters, collecting and compiling information and documents and either timely responding to, or proposing draft responses to legal correspondence for counsels final review. Draft documents, including proposing responsive pleadings or other legal documents for counsel, compile, update, and manage all...