14 jobs found in Reston

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Leads, manages and empowers Medicare Advantage (MA) Employer Group Waiver Plan (EGWP) operations teams to meet and exceed business delivery. Serves as a tactical and strategic leader of multifunctional teams and support roles for MA EGWP. Be able to step-in as subject matter expert in all aspects of MA EGWP operations. Oversees development of new activities of an internal function that provides operational/business process support to internal and external customers for the new EGWP product launch. Ensures quality service and operational performance within the parameters of program and delivery standards are achieved, including CMS required standards. Develops, analyzes operational processes, establishes escalation procedures and oversees training needs assessments to identify opportunities for service delivery improvements. Selects, develops, and evaluates employees to ensure efficient operation of the...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Sr. Business Consultant provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives in the changing healthcare industry ESSENTIAL FUNCTIONS: Provide subject matter expertise in a particular area (including but not limited to one of the following: project management, finance and budget, human resources, data and metrics, information technology, etc.) that contributes to the effective accomplishment of initiatives tasks and goals. Collaborate on the business strategy, thesis, programs and the identification of strategic opportunities. Proactively build and lead cross-functional teams and projects between division, and internal and external stakeholders to deliver value to supported team. Proactively identify ways, means, and platforms to build synergy and mutually reinforcing workstreams to accomplish tasks more effectively across...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This position oversees and directs the work of analysts in a supervisory capacity. This position is responsible for implementing departmental strategy and policies in order to meet team goals, as well as making recommendations to Actuarial management where appropriate. ESSENTIAL FUNCTIONS: Responsible for coordinating the activities analysts ensuring accurate and timely release of requested analyses and reports. Responsible for providing training, development, documenting performance issues, if needed, and monitoring and enforcing adherence to Company policies. The Supervisor sets objectives, writes and deliveries performance feedback and appraisals, promotions, salary increases, hiring and disciplinary communications. Responsible for coordinating the development and extensive analytical review of various actuarial analyses such as IBNR, trend, rating actions, and valuation work in support of...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Leads the delivery of Medicare Advantage Employer Group Waiver Plan (MA EGWP) technology product build roadmaps. These technology products and modernization programs are complex, large scale and have a strategic impact on Blue Cross Blue Shield Plans nationwide. Responsible for delivering these products on time and on budget. Serves as single point of accountability for the development and delivery of specific lines of business product lines. ESSENTIAL FUNCTIONS: Defines the strategy for delivering of MA EGWP technology product roadmaps deployed to meet the current and future strategic goals, risk management imperatives, and mandates on a national scale. Creates a legacy modernization roadmap to enable strategic goals and delivers the capabilities defined in the roadmap. Works closely with senior management to define new products and services that can meet current and future needs. Responsible for...

NFP Who We Are: NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance who has also earned the WORK180 employer endorsement. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com. Job Summary: This is a full-time, exempt, support position assisting the Account Team in the management of the existing BOB with emphasis in full retention responsibility. The primary function of this position is to provide quality service to clients and cross-sell/account-round within the existing book of business. The Account Manager (AM) will be the day-to-day liaison between the insurance company and designated middle-market accounts. You will manage and control relationships with clients in...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Lead Data Engineer is responsible for orchestrating, deploying, maintaining and scaling cloud OR on-premises infrastructure targeting big data and platform data management (Relational and NoSQL, distributed and converged) with emphasis on reliability, automation and performance. This role will focus on leading the development of solutions and helping transform the company's platforms deliver data-driven, meaningful insights and value to company. ESSENTIAL FUNCTIONS: Lead the team to design, configure, implement, monitor, and manage all aspects of Data Integration Framework. Defines and develop the Data Integration best practices for the data management environment of optimal performance and reliability. Develops and maintains infrastructure systems (e.g., data warehouses, data lakes) including data access APIs. Prepares and manipulates data using Hadoop or equivalent MapReduce platform. Provides...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Performs in a ServiceNow Senior developer position playing a key role in maturing Customer Service Products built on the ServiceNow platform. Performs complex analysis, design, development, 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, develops/codes, tests, and documents critical and complex application programs for computer systems. Works with appropriate stakeholders to define system scope and objectives and establish baselines. Establishes project standards and processes. Breaks down software requirements and creates highly complex systems. ESSENTIAL FUNCTIONS: Perform technical detail design, coding, testing of applications. Serves as subject matter expert for both customer and internal discussions related to maintaining and enhancing existing software...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The IT Business Relationship Manager is a senior level, highly adaptable and versatile individual contributor that will interface with business areas as a trusted advisor and advocate of Information Technology capabilities. This individual will serve as liaison for various activities, as driven by the business, relative to supporting process efficiencies, creating operational scale, technology enhancements, and proactive support for strategic and product development initiatives. The BRM is responsible for working with the business and key stakeholders to identify, analyze, and capture business value for each initiative while ensuring alignment with corporate strategy and IT roadmap. ESSENTIAL FUNCTIONS: Ensure delivery of technology value to the business by nurturing high level long term relationships, sensing business ideas and promoting the value of IT in delivering business solutions. Measure,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The VP, MA Business provides leadership for the operation of the Medicare Business in cooperation with the Blue Cross Blue Shield Association (BCBSA) and as part of the Service Benefit Administrative Services Corporation (SBP), which is a subsidiary of CareFirst and jointly owned by CareFirst and BCBSA. They will provide strategic direction for the development and expansion of the business, and ensure financial stability, growth, and compliance of the business. The VP will have responsibility for business direction, financial performance, alignment with the BCBSA, product direction, and multi-year strategy necessary to deliver the overall BCBSA MA Wrap strategic plan. Through collaboration with matrix leaders in SBP and across CareFirst (technology, finance, operations, compliance), the BCBSA and BCBSA Plans, and others, the VP will drive effective operations, financial performance, contractual compliance,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Business Consultant provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives in the changing healthcare environment. ESSENTIAL FUNCTIONS: Provide subject matter expertise in a particular area (including but not limited to one of the following: project management, finance and budget, human resources, data and metrics, information technology, etc.) that contributes to the effective accomplishment of initiatives tasks and goals. Collaborate on the business strategy, thesis, programs and the identification of strategic opportunities. Support cross-functional teams and projects between division, and others to deliver value to team. Proactively identify ways, means, and platforms to build synergy and mutually reinforcing workstreams to accomplish tasks more effectively across different business functions of initiatives. Design...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Sr. Business Consultant provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives in the changing healthcare industry ESSENTIAL FUNCTIONS: Provide subject matter expertise in a particular area (including but not limited to one of the following: project management, finance and budget, human resources, data and metrics, information technology, etc.) that contributes to the effective accomplishment of initiatives tasks and goals. Collaborate on the business strategy, thesis, programs and the identification of strategic opportunities. Proactively build and lead cross-functional teams and projects between division, and internal and external stakeholders to deliver value to supported team. Proactively identify ways, means, and platforms to build synergy and mutually reinforcing workstreams to accomplish tasks more effectively across...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Performs in a ServiceNow Architect and Lead Developer position and will play a key role in maturing Customer Service Products built on the ServiceNow platform. Will be a principal lead for ServiceNow code and architecture, and work with key business units and process managers to build solutions and processes, supporting maintenance, continual service improvement, and new capabilities on the ServiceNow platform. Implements the engineering best practices required to produce and deploy high quality products. Ensures engineering alignment with functional and technical requirements. Handles the design, implementation, testing, and maintenance of products as assigned, ensuring that they are consistent with the company's architectural roadmap, product development strategy, and quality standards. Develops project plans with estimates and ensures development stays organized and adheres to the plan. Leads stakeholder...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Ensures the stability, integrity and efficient operation of the organization information systems that support organizational functions. This is achieved by monitoring, supporting and optimizing all networked software and associated operating systems. Assesses architecture and current system limitations, defines and designs system specifications, disaster recovery procedures and evaluates input/output processes and working parameters for hardware/software compatibility. We are looking for a Systems Engineer to manage and support enterprise endpoints and drive the integration of Microsoft Copilot across the organization. This dual-focus role ensures the security, stability, and performance of both physical and virtual desktops, while also engineering Copilot features to enhance user productivity and automation. Responsibilities include endpoint management, software packaging for virtual Desktop...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Defines, designs and develops system requirements. Performs trade-off analysis of performance, life-cycle cost, risk, producibility, and other system or program requirements. Assesses architecture and current hardware limitations, defines and designs system specifications, and evaluates input/output processes and working parameters for hardware/software compatibility. Coordinates design of subsystems and integration of total system. Defines system support requirements to include monitoring, capacity, staffing and patching/updating. Analyzes and resolves program support deficiencies. Conducts independent technical investigations in systems design. ESSENTIAL FUNCTIONS: Installs, tunes, upgrades, troubleshoots, and maintains all computer systems relevant to the supported applications including all necessary tasks to perform operating system administration, user account management, disaster recovery...