75 associate director jobs found in Baltimore

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This position serves as a key liaison between the Cost Accounting/Finance function and the other divisions throughout the organization. This role is responsible for analyzing data, performs various Cost Accounting functions requiring knowledge of the theory and practice of recording, classifying, examining, and analyzing corporate data and financial transactions of the organization. This position also provides financial support to the business, through analysis of cost accounting documents and results; and interacts regularly with business owners, data suppliers, and other finance division teams. This role is responsible for optimizing accounting systems and processes, enhancing reporting capabilities and ensuring accurate and efficient financial operations. Additionally, this role helps prepare and produce statutory and financial reports for regulatory bodies and internal stakeholders, along with analyzing...

CareFirst BlueCross BlueShield Resp & 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. The critical responsibility will be the management of care delivery in a cost effective and quality assured system that will assist the organization to achieve its corporate mission of serving the health needs of members. ESSENTIAL FUNCTIONS: Ensure that the provision of health care service to the membership is compliant with the medical policies and standards. Participate in medical necessity reviews, including pre-service reviews, concurrent reviews of inpatient and post-acute care, and appeals. Serves as key resource for network physicians for peer-to-peer case discussion. Provides clinical support for utilization review, care management and quality to determine the medical effectiveness of proposed...

CareFirst BlueCross BlueShield Resp & Qualifications Candidates must live in the MD/DC/VA surrounding areas in order to travel frequently into the offices and client meetings. PURPOSE: Are you ready to lead a dynamic team and drive strategic growth in the commercial market segment? As the Director of Commercial Accounts, you will provide visionary leadership to the 51-99 commercial Account Consultants, ensuring maximum customer retention and ancillary growth. This pivotal role involves overseeing, managing, and directing the team to boost sales volume for our commercial employers, while also contributing to the achievement of our corporate goals. ESSENTIAL FUNCTIONS: Team Leadership: Inspire and manage a talented team of Account Consultants, ensuring top-notch performance and professional development. Retention & Growth: Achieve retention, renewal, and financial goals for medical and specialty products within the 51-99 commercial segment....

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Inpatient Management Onsite Care Management Supervisor will direct and coordinate the activities of Onsite Care Management staff, Onsite Clinical Navigators and/or other Registered Nursing roles embedded at a partnering hospital. This role will assist leadership with the development and review of Care Management standards, program criteria, policies, and procedures to ensure quality of care and manage healthcare costs. The incumbent will function as a liaison working onsite at partner hospitals up to 5 days a week. Based on hospital assignments and admission volumes on a week-to-week basis, management may occasionally approve the onsite care management supervisor to perform limited functions telephonically, at its sole discretion.The candidate may also be required to come to the CareFirst office location periodically for meetings, training, or other business-related activities. The candidate's primary...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Assistant General Counsel II provides a complete range of highly specialized legal services in support of the General Counsel, Deputy General Counsel, Director, Managing Assistant General Counsel, and executive management in the Division(s) to which the Assistant General Counsel is assigned, and may represent CareFirst, Inc., its subsidiaries, and/or affiliates ("the Corporation") in litigation brought by and or against it. The Senior position is expected to work independently and provide high-level executive support. This position will support the Company's care delivery operations, including comprehensive representation of various provider entities. ESSENTIAL FUNCTIONS: Legal Advice Provides written and oral advice directly to executive management and/or their designees in complex and rapidly evolving areas of the law. Analyzes and provides legal guidance on a wide range of regulatory,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: In collaboration with the Medical Director, the Medical Policy Analyst will research, analyze, evaluate, and revise medical policies and operating procedures to support the corporate philosophy, provider and member contracts, and accepted standard of medical practice. We are looking for an experienced professional 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: Performs in-depth research on medical topics identified in existing medical policies and operating procedures scheduled for revision or updates based upon changes in the standard of care. Evaluates current peer-reviewed articles and other literature to determine its appropriateness of clinical guidance and mandated legislation in support of and inclusion in...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Join our team to lead the creation of CareFirsts next-generation Integration Platform, seamlessly blending API-first design with a product-based approach to advance our cloud-native strategy. Play a pivotal role in transforming how we operate, enabling faster innovation, streamlined execution, and cost-effective solutions that scale across our Enterprise Portfolio. CareFirst is undertaking a digital transformation which requires enterprise agility paired with the retooling of our technology stack to speed-up delivery and to expand our reach. The Digital Factory organization is leading this charge by advancing our Scaled Agile Framework (SAFe) ways of working across the organization. To drive this transformation, the Platform Engineering Manager is a key role within the Integration & Interoperability team that builds technical depth, expertise, and resource management within the Nexus platform....

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: The main purpose of a data analyst is to find meaning in data as a thought leader so that the derived knowledge can be used to make informed decisions and assist the organization in making better business decisions. ESSENTIAL FUNCTIONS: Engages in data exploration using various programming languages (reading and writing code), requiring advanced knowledge of multiple database structures Collect, analyze, and interpret data to glean insights, and develop business appropriate recommendations Serve as an expert resource supporting data questions and issues from...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Manages end-to-end oversight of the Stored Information Retrieval (SIR) system and related operational processes including front-end mail room services, document scanning and digital record storage related to member and provider submitted paper claims, correspondence, appeals, finance checks, enrollment forms and provider credentialing forms. Drives teams and internal projects to maintain and enhance program performance over time. Guides stakeholders through key decisions, communicates and coordinates activities internally and across departments. Facilitates process improvement and identifies and articulates stakeholder needs to drive strategies and maximize outcomes related to ROI, customer satisfaction, and organizational metrics and performance. Takes full ownership of all components of program from day to day tasks to building road maps, driving strategy and leading organization wide initiatives...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Performs advanced actuarial and oversight skills in the performance of actuarial analytics to develop actionable items in support of departmental goals Provides actuarial leadership support to Medical, Pricing, Underwriting, Sales, Finance and other applicable Business Units. Responsible for actuarial modeling to support financial objectives. and making recommendations to executives and senior management. ESSENTIAL FUNCTIONS: Responsible for directing the efforts of Actuarial staff (Pricing, Actuarial Finance, Actuarial Medicare Advantage, Actuarial Innovation and Research) to accomplish near and long-term goals set by senior management. In collaboration with senior management, responsible for setting long term strategy within the Actuarial department. Responsible for representing the Actuarial department to internal and external customers including state and federal regulators. Hiring, recruiting...

Logitech Logitech is the Sweet Spot for people who want their actions to have a positive global impact while having the flexibility to do it in their own way. The Team and Role: Logitech is seeking a highly motivated and experienced Sr. Tax Analyst, Transfer Pricing (TP) advisor to join our dynamic tax team. This role is a key position within our Tax department and requires the ability to work collaboratively across functional teams within tax and outside of the tax department. The role will focus on a variety of projects extending from operational and compliance, to advisory, planning, and audit defense. The role will also develop strategies and provide guidance on TP tax technology initiatives including the use of Artificial Intelligence. You will be responsible for ensuring our intercompany transactions across various jurisdictions are compliant with local and international tax regulations, including the OECD Guidelines. Your Contribution: Be Yourself. Be...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Executes medium to complex sourcing projects, from start to finish. This role will rationalize the supply base through strategic sourcing, lead cross-functional team to achieve optimal total cost of ownership, identify cost savings opportunities across the company, support overall supply requirements and ensure an effective spend analysis for assigned category. ESSENTIAL FUNCTIONS: Provides sourcing services (RFx, reverse auctions, negotiations) to clients based on predefined service levels, managing 5-12 simple to complex projects simultaneously with limited supervision/guidance or independently. Executes sourcing strategy by leading formal sourcing processes including stakeholder engagement, RFP processes and contract negotiations. Assists in the development of category sourcing strategy leading cross-functional teams to execute the sourcing strategy. Partners with customer groups to establish...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Appeals Specialist I is responsible for the initial analysis of appeals and/or grievance correspondence, and determination of next steps for Commercial and FEP lines of business. Responsible for collecting, organizing and tracking information to facilitate and expedite processing of appeals and/or grievances received from a variety of sources. We are looking for an experienced professional 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: Prioritize, research and analyze all pertinent information in preparation of an appeal and/or grievance request. Access the appropriate database to implement accurate and timely entry of appeal, grievance and/or reconsideration correspondence and updates the appropriate referral...

Transamerica Job Family Product Development / Implementation About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment - one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we're part of an international holding company, with millions of customers and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Broker Relations Manager's primary responsibility is to bring the value of CareFirst to the marketplace by engaging and working with CareFirst's distribution channel (brokers). This role combines strategic leadership with hands-on management to ensure brokers receive timely, accurate, and comprehensive assistance. The ideal candidate will foster a customer-centric culture while driving operational excellence and team development. ESSENTIAL FUNCTIONS: Broker Relationship Management Serve as the primary escalation point for complex broker inquiries and issues, ensuring timely and satisfactory resolution. Build and maintain strong relationships with key broker partners, full service producers and consultants, understanding their needs and business objectives. Monitor broker satisfaction metrics and implement strategies to improve service delivery and partner experience. Collaborate with sales...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This position maty be responsible for preparing analyses associated with the development of reimbursement policy, strategies, cost of care impacts and work flows for healthcare providers' reimbursement fee levels. The incumbent will work with various commercial and government program related fee schedules, develop recommendations and prepare competitive analyses to include industry, regional, and internal benchmarks. Will be responsible for reviewing and analyzing information for various provider reimbursement and network strategy projects, preparing routine reports and fee disclosure related documents. Knowledge of Medicare or Medicare Advantage products preferred. We are looking for an experienced professional to live and 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...

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 CANDIDATES MUST LIVE IN THE MD, DC, NORTHEN VA AREA IN ORDER TO TRAVEL INTO THE OFFICES AND FOR CLIENT MEETINGS AND STAFF MEETINGS. PURPOSE Manages and supports the sales growth and retention of assigned Account Consultants for Mid-Market (51-99) market segments. Conducts sales and service to assigned accounts. Monitors the development and implementation of strategic long-term customer relationships. Achieves targeted Retention Sales goals for the unit. ESSENTIAL FUNCTIONS Develops account strategies in accordance with overall strategy. Works with the team and Brokers to maximize retention and growth. Manages the Renewal support/service functions essential to day-to-day account, service, productivity, implementation and retention. Develops account goals and business plan with customer. Conducts regular reviews of business performance, promotion strategies, and planograms. Forecasts, budgets, and tracks...

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 This role is a Hybrid position with 10-24 days per quarter in our Baltimore City, Columbia, MD or Washington DC office. PURPOSE: The Employee Relations Specialist partners with employees, managers and Human Resources Business Partners to investigate and bring resolution to employee relations issues that provide fair and consistent treatment to all employees, and in a manner consistent with the company's policies, procedures, and state and federal law. ESSENTIAL FUNCTIONS: Conducts basic/moderately complex HR investigations, including intake processes, investigation planning and interviews, recommendation and determination, and reporting/insights analysis. Communicates and updates status of investigations to relevant managers and HRBPs. Collects and maintains evidence, including testimonial and documentary evidence, for use in drawing investigative conclusions. Draft summary reports detailing findings resulting...