12 associate solution consultant jobs found

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: Provides strategic and tactical planning, as well as, knowledge services relating to the implementation of key mandate initiatives, covering a broad range of legislative and regulatory matters including: Federal, BCBSA, Government Programs, State. Provides internal and external liaison functions, workflow, customer service, communications, training, strategic delivery, efficiency, cost reduction and skill development initiatives. We are looking for an experienced professional to work remotely. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: Analyzes legislation and regulations as it relates to CareFirst and creates high level compliance requirements. Primary/dedicated Regulatory point of contact for Project Managers who implementation projects. Takes a lead role in various...

Apex Systems, Inc. Job#: 3027594 Job Description: For immediate response, please send to [email protected] : Updated WORD resume, desired hourly/salary rate, and best time to speak! Job ID: 3027594 Position : Secret Cleared RF Engineer Location : Pax River, MD (HYBRID - 3 days' onsite) Duration : 6 Month Contract to Hire (4 years left on the contract) MUST HAVES: Ability to obtain and maintain a Secret Clearance (willing to obtain TS/SCI) | Bachelor's and 10+ years of Experience Handson electrical/electronic design, build, repair, adjustment, and modification of components Ability to effectively communicate project updates, adjustments, and overall status The Opportunity: As an engineering technologist on our team, you'll apply your theoretical and practical knowledge of electronics to your client's programs and technical problems. You'll work with our engineers and government client to design, develop, and test technical solutions for...

NFP Who We Are: Wealthspire is a leading wealth management, retirement advisory, and business management firm serving individuals, families, endowments, and institutions across the United States, Canada, and the United Kingdom. We provide a comprehensive platform that brings together wealth management, institutional consulting, business management, family office, and retirement plan advisory services—empowering clients to navigate complexity with clarity and confidence. With over 1,200 employees across more than 40 offices, we deliver insights and solutions backed by deep research, technology, and decades of expertise. Our collective businesses create a unified ecosystem designed to meet clients wherever they are in their financial journey. Wealthspire is redefining the future of financial solutions through collaboration, scale, and a steadfast commitment to putting people first—our clients, our colleagues, and our communities. For more information, visit...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Acts as an internal expert to ensure that as value-based reimbursement and medical policy models are developed and implemented. Provides advanced knowledge to support effective partnership with provider entities and guidance on the appropriate quality measure capture and proper use of CPT and ICD 10 codes in claims submissions. Utilizes extensive coding knowledge, combined with medical policy, credentialing, and contracting rules knowledge to help build the effective guides and resources for providers on the expected methodologies for billing and code submissions to maximize quality for FWA prevention. ESSENTIAL FUNCTIONS: Consults on proper coding rules in value-based contracts to ensure appropriate quality measure capture and proper use of CPT and ICD10 codes. Provides input on various consequences for different financial and incentive models. Supports to use of alternatives and solutions to...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Acts as an internal expert to ensure that as value-based reimbursement and medical policy models are developed and implemented. Provides expert knowledge to support effective partnership with provider entities and guidance on the appropriate quality measure capture and proper use of CPT and ICD 10 codes in claims submissions. Utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge to build the effective guides and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. Provides expertise and mentoring to other team members. 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...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Sr. Business Consultant ACA Individual serves as a strategic subject-matter expert responsible for designing, launching, and executing initiatives that advance organizational goals within the evolving healthcare landscape. This role is integral to driving ACA market growth by: Defining and implementing the ACA Operating Model and Playbook Partnering across matrixed teams to lead initiatives with the goal of increasing CareFirst market share, improving member/broker experience, and strengthening ACA Individual performance. Developing ACA dashboards to strengthen enterprise alignment with key performance indicators (KPIs) ESSENTIAL FUNCTIONS: Lead the development of the ACA Individual Operating Model and Playbook, ensuring clear end-to-end ownership of all ACA processes and alignment with defined KPIs, strategic priorities, and performance targets. Proactively identify, evaluate, and execute...

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. ACTIVE HEALTH AND LIFE LICENSE IS REQUIRED. PURPOSE: As a key member of our Account Management Team, the Account Manager II plays a pivotal role in driving client success and business growth. This position combines strategic consulting, relationship management, and marketing expertise to deliver exceptional value to our clients. Youll serve as a trusted advisor, promoting our suite of benefits and services, and leading initiatives that enhance client satisfaction, increase enrollment, and strengthen long-term partnerships. ESSENTIAL FUNCTIONS: Drive Growth & Engageme nt: Lead the charge in growing group enrollment by marketing directly to client associates. Plan and execute impactful communication and education strategies that resonate with diverse employee...

CareFirst BlueCross BlueShield Resp & Qualifications CareFirst runs a year-roundinternship program. The ideal candidate is someone who can commit to work throughout the year part-time up to 15-20 hours in the Spring/Fall AND full-time 40 hours in the Summer. ESSENTIA FUNCTIONS: Gather and analyze clinical data related to high-cost claimants and utilization pattens driving cost trends Create PowerPoint presentations Support day to day operational process and identify streamline opportunities Work under Clinical Advisors and Wellbeing Consultants to learn and lead strategies and go to market solutions Represent CareFirst at client meetings and wellness events (as appropriate and available) Understand the full continuum of wellbeing products and service in-depth QUALIFICATIONS: Must be a student enrolled in an accredited College or University working towards a Graduate level degree Target Majors: Business Administration, Healthcare Management, Project...

Aledade The Electronic Health Record (EHR) Optimization Lead will play a key role in optimizing EHR solutions that enable Aledade's partner practices to improve patient outcomes, reduce healthcare costs, and increase efficiency. They will collaborate with practice stakeholders along with the multi-disciplinary Aledade team to identify, develop, and implement EHR solutions to support strategic ACO initiatives. Additionally, this role will facilitate the collection of practice-generated data that can be used for population-based analytics. They will have depth of knowledge in at least one top-tier ambulatory EHR solution, have a strong understanding of practice workflow, and be able to travel periodically. The EHR Optimization Lead must thrive in a fast-paced environment, respond well to change, and be a strong verbal and written communicator. The EHR Optimization Lead will be responsible for providing multi-program leadership and serving as a mentor to team members....

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 the most complex and jumbo 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...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This role manages the appeal process for members and providers who appeal on behalf of members for Commercial lines of business. Ensures quality management of the clinical appeal process to reduce the risk of State and Federal Regulatory fines and sanctions, avoid adverse exposure, reiterate the expectation of a fair and compliant appeal process for our membership, and support NCQA accreditation and the Divisional Goals for Care Management. We are looking for an experienced clinical leader in the greater Baltimore 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. ESSENTIAL FUNCTIONS: Develops, establishes and implements a compliant appeal process with dynamic goals resulting in the full and...