80 associate jobs found in Baltimore

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This entry level position is responsible for the attainment, effective management, and profitability of a designated book of business. This position utilizes underwriting judgment and exercises a level of authority. Pricing concessions are permitted up to the designated level of authority without further review. This position works closely with Sales and Account Management to ensure that client needs are met ESSENTIAL FUNCTIONS: Works closely with the Account Manager and Underwriting Manager to provide alternate benefit plans, risk and/or funding arrangements. Update appropriate billing rate files, contracts, internal databases, etc. Complete the renewal process on smaller accounts, complete/update ASO and Stop Loss contracts and quote alternate funding arrangements with assistance from senior underwriter, consultant or management. Support attainment of corporate sales and profitability goals...

McGuireWoods Job Description: The Baltimore office of McGuireWoods seeks an Associate to join its Financial Services and Securities Enforcement Department. The cornerstone of McGuireWoods' financial services and securities enforcement group is the team's ability to effectively represent the interests of the vital, growing and increasingly complex financial services sector. This representation includes securities, lender liability, regulatory issues, loan workouts, foreclosures, class actions and credit card-related matters. Lawyers' experience encompasses the expanding services offered by financial institutions, including recent cases involving securities fraud, failed asset securitizations and defaulted syndicated loans. The firm also represents banks in connection with commercial disputes, business torts and intellectual property matters. McGuireWoods, one of the world's leading law firms, has provided legal solutions to corporate, individual and nonprofit clients since...

McGuireWoods Job Description: The Baltimore office of McGuireWoods seeks a Financial Regulatory Associate to join its Financial Services and Securities Enforcement Department. The cornerstone of McGuireWoods' financial services and securities enforcement group is the team's ability to effectively represent the interests of the vital, growing and increasingly complex financial services sector. This work includes advising clients in cutting-edge payments products, state and federal regulatory inquiries, rulemakings, money transmission, lobbying and legislative affairs, licensing, product counseling, intellectual property, and compliance obligations across domestic and international markets. McGuireWoods, one of the world's leading law firms, has provided legal solutions to corporate, individual and nonprofit clients since 1834. Along with excellent benefits, McGuireWoods offers our attorneys a competitive salary with hours and merit bonus opportunities and billable hours...

McGuireWoods Job Description: The Baltimore office of McGuireWoods seeks a Mid-level Associate to join its Public Finance Practice Group. McGuireWoods' nationally recognized Public Finance Practice Group within the firm's Public and Private Infrastructure & Real Estate Department guides clients through all types of tax-exempt and taxable financings for non-profit, higher education, for-profit, energy infrastructure, healthcare and similar clients. We help clients navigate all aspects of a financing or refinancing, including reviewing, drafting or analyzing underlying credit support, tax, construction and management agreements; drafting and negotiating all financing and offering documents, certificates and opinions; and reviewing and analyzing complex federal tax issues. Our work with public and private clients in the healthcare, energy, higher education, waste-to-energy, recycling, governmental, and industrial industries solidifies our reputation as a top national firm for...

CareFirst BlueCross BlueShield Resp & Qualifications CANDIDATES MUST LIVE IN THE MD, DC, NORTHERN 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 responsible for renewing/growing a book business which includes more complex accounts with indemnity and managed care medical products, ancillary/specialty products, and life products. You will be working with Public Sector accounts with various funding arrangements and plan sponsors within state, municipal and school boards ranging in girth from 100 to 100,000+ contracts. This position drives revenue and manages current and prospective relationships to ensure success with products. Leads sales initiatives and strategies within their assigned territory. Achieves sales and profitability objectives by effectively managing new and existing accounts. ESSENTIAL FUNCTIONS: Ensures that each assigned account...

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: Responsible for maintaining admin rates, preparing and delivering invoices to bring in revenue for the organization. This includes establishing and following required technical specifications, managing the accuracy and efficiency of the established process as well as identifying and resolving data and setup issues as it relates to internal billing systems. The incumbent is also responsible for remitting payment to client vendors within proper timeframes to ensure late fees are not charged. ESSENTIAL FUNCTIONS: Compiles, validates and supports financial data for upload to financial systems to ensure accuracy of financial statements. Establishes and maintains comprehensive Excel spreadsheets for cash application and reconciliation to daily bank statements to ensure the bank and internal financial systems are in sync. Audits ancillary vendor payments to ensure accuracy of remittances. This involves...

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: Responsible for maintaining admin rates, preparing and delivering invoices to bring in revenue for the organization. This includes establishing and following required technical specifications, managing the accuracy and efficiency of the established process as well as identifying and resolving data and setup issues as it relates to internal billing systems. The incumbent is also responsible for remitting payment to client vendors within proper timeframes to ensure late fees are not charged. ESSENTIAL FUNCTIONS: Compiles, validates and supports financial data for upload to financial systems to ensure accuracy of financial statements. Establishes and maintains comprehensive Excel spreadsheets for cash application and reconciliation to daily bank statements to ensure the bank and internal financial systems are in sync. Audits ancillary vendor payments to ensure accuracy of remittances. This involves...

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: Supervise and provides daily direction to multi-functional team members regarding training and development, policies, procedures, and work production quantity and quality. Functional areas may include but not limited to: installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Reviews and resolves complex service issues not resolvable by subordinates. ESSENTIAL FUNCTIONS: Supervise employee outcomes by training, assigning, scheduling, coaching, and counseling employees; communicating job expectations; planning, monitoring, and appraising job contributions; adhering to policies and procedures. Meets operational standards by contributing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service; resolving problems; identifying...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Privacy Specialist will assist Privacy Management with the development, implementation, and ongoing management of CareFirst's privacy program. The Privacy Specialist will interact with all levels of the organization and function as an integral team member in advancing the overall security, privacy and compliance program with respect to privacy-related policies, procedures, operational workflows, laws and regulations. ESSENTIAL FUNCTIONS: Performs administrative work associated with protected health information requests. Collaboration with legal counsel and management, key departments, and committees to ensure organization has and maintains appropriate privacy and confidentiality consent, authorization forms, and information notices and materials reflecting current organization and legal practices and requirements. Implement privacy & compliance procedures providing oral and written...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Data Analytics Intern role exists as a hiring strategy to bring in students enrolled in an accredited college or university who are pursuing at least a Bachelors degree in analytical and/or data visualization related fields to learn the business and technical side of healthcare from the ground up. Data and Analytics creates cutting edge analytic tools/visualizations to drive insights and faster decision making within the organization and provides critical support for key corporate initiatives. This role will require interaction with project stakeholders and business partners within the organization. This position will use analytically derived insights to develop and test solutions that enhance consumer engagement, improve health outcomes and reduce health care costs. This is a fast-paced, collaborative, and iterative environment requiring quick learning, agility and flexibility. This is a Year-Round...

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 CANDIDATES MUST LIVE IN THE MD, DC, NORTHERN VA AREA IN ORDER TO TRAVEL INTO THE OFFICES AND FOR CLIENT MEETINGS AND STAFF MEETINGS. PURPOSE: This position is responsible for renewing/growing a book business which includes the most complex and jumbo accounts with indemnity and managed care medical products, ancillary/specialty products, and life products. This position drives revenue and manages current and prospective relationships to ensure success with products. Leads sales initiatives and strategies within their assigned territory. Achieves sales and profitability objectives by effectively managing new and existing accounts. ACTIVE HEALTH AND LIFE LICENSE IS REQUIRED. ESSENTIAL FUNCTIONS: Ensures that each assigned account renews annually and aggressively pursues growth within groups by developing and implementing account specific benefit and financial strategies. Manages and develops a set of...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Supports Benefit Contract Management (BCM) by assisting or performing accountabilities/tasks that include but are not limited to: revising/updating contract forms and templates; reviewing contract forms, templates and related marketing materials; preparing electronic filings via SERFF; tracking status of filings; creating sample contracts; creating SBCs; organizing and circulating contract related documents; and contributing to BCM strategies and process improvements. ESSENTIAL FUNCTIONS: Reviews, clarifies and/or interprets customized/nonstandard benefit requests; provides information and decisions to operations, account implementation meetings, and other company initiative implementation meetings needed. Clarifies and ensures consistency of contract benefits with respective system benefit coders. Revises/updates contract forms and templates as appropriate and assigned. Assist or performs electronic...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Associate General Counsel provides a complete range of legal services in support of the Assistant General Counsel, Litigation General Counsel, and the Division(s), Department(s), and/or specialized areas of legal practice to which the position is assigned with a focus on regulatory, compliance, litigation, and employment law. ESSENTIAL FUNCTIONS: Provides advice and counsel to management and/or their designees in complex and rapidly evolving areas of the law; evaluates divisional and departmental initiatives and represents the corporations legal interests on intercompany management committees; researches, analyzes and writes legal memoranda and provides legal guidance on a wide variety of legal, regulatory, contractual, compliance, corporate governance and operational matters, including the interpretation and implementation of legislation; assists with and/or supports representation of the...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This role is accountable for directing all aspects related to the monitoring of performance under the Medicaid contract and regulatory requirements and the overall state of compliance for Medicaid and Medicaid products. Reporting to the CEO, Plan Board of Directors, and Corporate Compliance Officer, the incumbent works closely with operational teams, Corporate Compliance, Mandates and Legal departments to resolve complex issues with inter-related legal and Medicaid compliance aspects. ESSENTIAL FUNCTIONS: Direct accountability for establishing an effective compliance program based on the seven core elements of compliance. Directs the activities related to the design, development, implementation and maintenance of compliance programs across all major functional areas and vendors for Medicaid within the division. Ensures internal departments understand and implement CMS and applicable state rules,...

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,...