56 clinical director jobs found

Aledade Market Managers serve as dynamic project managers and people leaders who drive transformational change across their healthcare markets, ensuring practices not only meet but exceed quality and savings targets that directly impact patient outcomes. These strategic leaders work in close partnership with their Market President/Executive Director to develop, implement, and execute market-wide strategic initiatives that advance value-based care goals. Through expert guidance and coordination of Practice Transformation Specialist teams, Market Managers create the operational framework that enables practices to thrive in value-based care while delivering measurable improvements in both clinical quality and cost efficiency. This role combines hands-on leadership with strategic vision, positioning Market Managers as the critical bridge between executive strategy and frontline practice transformation success. Please note: only candidates residing in Maryland, Delaware, and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This position will support the modernization and redesign of the utilization management department through thoughtful contributions to process analysis, mapping, and managing process improvements made in alignment with goals for the department and organization. Supports the analysis and evaluation of business problems and the development of solutions to address identified problems, using deep understanding of the utilization management function and workflows. Provides a single point of contact for those projects. Takes projects from original concept through final implementation. Assignments typically include problem definition, evaluation of requirements, and facilitation of the implementation of systems and/or process to meet business and user requirements. We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Director, Pharmacy Services is responsible for implementing the organization's pharmacy vision and strategic plan for government programs including Maryland Medicaid, Dual Prime Special Needs Plan (DSNP), and Medicare Advantage products. This role has oversight of pharmacy staff and develops and maintains collaborative relationships with clinical, administrative, and other key stakeholders including external vendors to ensure effective operations and value realization of pharmacy programs. This role also serves as a key point of contact with the Maryland Department of Health (MDH) and U.S. Centers for Medicare and Medicaid Services (CMS). ESSENTIAL FUNCTIONS: Provides oversight and support for the management of multi-faceted Pharmacy Services Government Programs to reduce pharmacy spend, total cost of care, and improve health outcomes. Supports programs from evaluation through implementation and value...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Pharmacy Supply Chain Director is responsible for leading critical financial and analytic functions within the Pharmacy Management department. This role ensures the organization maximizes contractual value by overseeing reconciliation of pharmacy rebates and network discounts with the PBM and medical rebates with Synergies, delivers timely and accurate rebate and discount calculations to self-insured ASO/CFA accounts, and builds, maintains, and enhances enterprise pharmacy data and analytics capabilities ESSENTIAL FUNCTIONS: Pharmacy Supply Chain (Pharmacy & Medical Rebate Reconciliation): Lead the end-to-end reconciliation of all pharmacy rebates, network discounts, and medical rebates to ensure contractual financial guarantees are met. Interpret multiple complex contract terms, conditions, definitions, and financial guarantees, translating them into claim-level mapping and reconciliation...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Shape and execute reporting strategy for data collected. Help drive critical business decisions by analyzing metrics and designing reports. Communicate results to stakeholders and provide suggestions based on findings. ESSENTIAL FUNCTIONS: Collaborates with stakeholders to understand data needs to create reports that meets the needs of the business. Identifies functional requirements through process analysis, review of documents and procedures, and interviews and meetings with stakeholders. Occasionally works alongside Developers and the System Architects to use the requirements to design the system concept of operations from both business and technical perspectives. Analyzes data and develops observations and findings based on analysis. Creates and test reports utilizing feedback and revisions into reporting products. Conducts quality control, communicates findings, and obtains sign-off from...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Digital Marketing Project Manager Provider & Member Engagement leads the planning, execution, and optimization of digital communications across email, web, SMS, and mobile-first channels. This role manages campaigns that support both member and provider audiences, ensuring timely, compliant, and engaging communications that align with organizational goals and customer experience strategies. ESSENTIAL FUNCTIONS: Manage end-to-end project delivery for mobile engagement/SMS, email, and web campaigns targeting both member and provider audiences. Develop project plans, timelines, budgets, and resource allocations for lifecycle, operational, and promotional communications. Coordinate with cross-functional teams including marketing, provider relations, business areas, clinical teams, compliance, analytics, product, and IT. Oversee campaign workflows from intake and strategy through build,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Develops and implements security solutions. Administers security technology systems. by architecting and engineering/developing trusted systems into secure systems. Assists in the development of implementation and deployment plans that are aligned to the organizational strategic plan objectives and security requirements. Advises management in developing cybersecurity policies, processes, and procedures. ESSENTIAL FUNCTIONS: Manage Splunk Cloud app and add-on deployments within FedRAMP boundary constraints, coordinating with Splunk support where cloud admin controls are limited: Respond to and resolve customer tickets related to data ingestion issues, search performance, access requests, and platform health. Administer user roles, access controls, and index permissions in alignment with HIPAA and FedRAMP compliance requirements. Maintain accurate documentation for all configurations, deployments,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Develops and implements security solutions. Administers security technology systems. by architecting and engineering/developing trusted systems into secure systems. Assists in the development of implementation and deployment plans that are aligned to the organizational strategic plan objectives and security requirements. Advises management in developing cybersecurity policies, processes, and procedures. ESSENTIAL FUNCTIONS: Manage Splunk Cloud app and add-on deployments within FedRAMP boundary constraints, coordinating with Splunk support where cloud admin controls are limited: Respond to and resolve customer tickets related to data ingestion issues, search performance, access requests, and platform health. Administer user roles, access controls, and index permissions in alignment with HIPAA and FedRAMP compliance requirements. Maintain accurate documentation for all configurations, deployments,...

Kaiser Permanente $8000 SIGN ON BONUS!!! Job Summary: Performs laboratory tests of moderate and high complexity and prepares records of test results. Maintains instruments, equipment, and supplies. Essential Responsibilities: Prepares and calibrates test instruments and equipment to assure accuracy of tests. Prepares and collects specimens and performs laboratory tests of moderate and high complexity as defined in laboratory procedures manual. Discusses unexpected or unreasonable test results to supervisor. Reports the results of each test and related test data by entering information in computer database. Prepares, distributes, and files forms and reports. Cleans instruments and equipment as needed following each test. Performs maintenance and minor repairs to instruments and equipment. Recognizes equipment malfunctions and notifies appropriate personnel. Assists newly assigned staff to learn laboratory procedures. Performs other related duties as directed....

Kaiser Permanente Job Summary: Provides medical equipment planning support for use in the architectural design and construction for moderately complex capital projects; independently develops equipment planning documents for new and existing care delivery environments with provision of technical and environmental requirements in support of contract documents; develops moderately complex medical equipment plans, including budgets and specifications, for KP medical facilities, major renovations, and expansion of existing medical facilities; establishes a communication network on moderately complex projects among the project team, facility, regional personnel, and equipment manufacturers/vendors; utilizes advanced knowledge of project management techniques to accommodate various internal and external stakeholder groups needs and conflicting demands to ensure the optimal use of medical equipment; and executes functional analysis, value cost analysis, and forecasting as it relates...

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...

PerkinElmer Responsibilities Location Gaithersburg, Maryland US Job ID REQ-056895 We are looking for a highly motivated Lab Services Supervisor - Consumables to provide critical, on-site, consumables inventory support as part of a dynamic PerkinElmer lab service team. The role is mainly responsible for inventory management, purchasing, shipping, receiving, storeroom tracking, and product delivery of consumables in support of our pharmaceutical customer. Other general lab responsibilities will also be required, all of which require high level of attention to detail in order to provide a quality service. This is a full-time position onsite in Gaithersburg, MD. Responsibilities: Provides day to day oversight of the Consumables Inventory Operations team, including coordination and responsibility for: Assignment of daily tasks Creation and direction of trainings Team communication Delegation of daily projects Responsible for performing all tasks that the...

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: The Property & Casualty, Commercial Lines Account Executive interacts with clients on a day-to-day basis while developing and maintaining relationships with both client and carrier representatives. You will prepare applications, specifications and marketing strategy for new business as well as the renewals of assigned clients with some degree of supervision and approval from your manager. You will manage a book of business comprised of middle markets to larger insurance clients with an...

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...

Wabtec Job Description Who will you be working with? Wabtec's Train Performance and Automation (TP&A) team is dedicated to de-risking and accelerating the commercialization of transformative technologies in the rail and transportation industry. The team plays a critical role in bringing next-generation products to market, including autonomous rail systems, intelligent controls, and AI-driven platforms. You'll work closely with engineering, operations, and commercial teams to deliver innovative solutions that support freight and passenger rail systems. How will you make a difference?   As a Product Manager for the Positive Train Control (PTC) product line, you will contribute to the strategy, development, and early-stage commercialization of innovative solutions from the TP&A team. You will own the product lifecycle from concept to deployment, working closely with engineering, business development, sales, marketing and customer teams to drive adoption and scale....

Wabtec Job Description Who will you be working with? The Product Engineer IV will be responsible for leading the design, development, and deployment of Digital Onboard Solutions Engineering (DOSE) Data Applications Product Line which includes products such as Locomotive Interface Gateway (LIG) and Expert On Alert (EOA). Additionally, the successful candidate will work closely with Product Management, Program Management and railroad customers to develop world class solutions that bring advanced automation and data analytics to the rail industry with high quality and reliability. The Product Engineer will be the technical architect developing long term strategy for the product line by leveraging industry experience, input from customers and collaboration with Product Management. The Product Engineering will be the focal point for all technical inquiries for the engineering department with respect to product line. They will interact with both internal and external engineering...

NFP Who We Are: NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance. 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. About Totalis Benefits: We are a leading General Agency specializing in providing expert support and strategic solutions to insurance Brokers and Account Executives. Our mission is to empower our partners with the tools, knowledge, and resources they need to delivery exceptional Life and Disability Insurance solutions to their clients. Position Overview: The Health & Benefits Operations Intern will support the Operations leadership team in advancing process improvement initiatives, strengthening business analytics, and helping design and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We are looking for an experienced Nurse Care Manager to work remotely from within the greater Baltimore, Maryland metropolitan area with both Adult and Pediatric members. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. Under minimal supervision, the Nurse Care Manager researches and analyzes the Adult and Pediatric member's medical and behavioral health needs and healthcare cost drivers. The Nurse Care Manager works closely with the member / members family 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. 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 Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication. The incumbent will handle pre claim medical review for Commercial and Federal lines of business. This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. This role will also understand the merits of legal or accreditation actions. We are looking for an experienced RN 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: Receives, researches, reviews and analyzes...