10 community manager jobs found in Baltimore

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...

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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 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Data Governance Equal Employment Opportunity CareFirst...

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 (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 Territory for this role includes Cecil, Kent, Queen Annes and Talbot Counties. Ideal candidate should reside in one of these counties. PURPOSE: Develop and implement strategies and community events to engage with the community, promote services, and build relationships with stakeholders for CareFirst BlueCross BlueShield Community Health Plan Maryland (CHPMD). ESSENTIAL FUNCTIONS: Develop Outreach Strategies: Create and implement effective outreach strategies to promote CHPMD in Eastern Shore Maryland communities. Community Engagement: Establish and maintain relationships with community organizations, stakeholders, and the public to foster collaboration and support. Events: Work with community partners and attend (e.g. table, provide education workshop, present on CHPMD Medicaid benefits) a minimum of 10 events per month, workshops, and initiatives to raise awareness for CHPMD. Assist in planning CHPMD...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns in their population's health data and effectuate practice transformation strategies that improve quality and reduce global health care costs. The Practice Consultant collaborates with internal subject matter experts to provide consulting services to physicians, key physician practice staff, executive level health system administrators, and other stakeholders to achieve program or contract goals. Participates in senior level peer workgroups to research and suggest new best practices and workflows to enhance the success of the consulting team. 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...

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...