68 healthcare jobs found

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health care services and compliance with UR policies/procedures, as well as regulatory and CareFirst's accreditation standards. We are looking for an experienced people 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: Supervise the daily operations of the UM staff. Recruits, retains and develops a high performing team. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policies and procedures. Ensure appropriate usage of resources in order to...

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. 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. 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. ACTIVE HEALTH AND LIFE LICENSE IS REQUIRED. ESSENTIAL FUNCTIONS: Ensures that each assigned account renews annually and aggressively pursues growth within groups by developing and implementing account specific benefit and financial strategies. Manages and develops a set of...

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....

Aledade The Enterprise Data Architect is a strategic leadership role responsible for the design and evolution of Alledade's Master Data Management (MDM) strategy and the architecture of our Business Data Warehouse. This role addresses the critical challenge of linking fragmented data across the customer lifecycle-from initial prospecting in Salesforce to contract management in Ironclad, through to operational and financial setup in Keystone, NetSuite, and QuickCap. As a Level 8 leader, you will move the organization away from manual, siloed data entry toward an automated, unified "Single Source of Truth." By leveraging our existing investments in Snowflake, DataHub, and MuleSoft, you will design the framework that allows the Business Intelligence (BI) team to extract high-value insights regarding revenue, performance, and overall organizational success. Primary Duties Enterprise Data Strategy & MDM Design MDM Architecture: Design the strategy and logical architecture...

American Red Cross Please use Google Chrome or Mozilla Firefox when accessing Candidate Home. By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spirit at its best. Are you ready to be part of the world's largest humanitarian network? Join us-Where your Career is a Force for Good! Job Description: We provide Paid-Training - no prior medical experience required! Phlebotomy experience preferred. Joining The American Red Cross is like nothing else - it's as much something you feel as something you do. You become a vital part of the world's largest humanitarian network. Joining a team of welcoming individuals who are exceptional, yet unassuming. Diverse, yet uncompromising in unity. You grow your career within a movement that matters, where success is measured in people helped, communities made whole, and individuals equipped to never stop changing lives and situations for the better. When...

Creative Circle Graphic Designer (Digital + Print) Web & Email Focus Location: Baltimore, MD (Hybrid ~3 days onsite/week) Schedule: 9:00 AM-5:00 PM Team: Digital Strategy Reports To: Head of Digital Strategy About the Role Our agency client is seeking a versatile Graphic Designer with strong digital design experience and solid print design skills. This is a hands on, execution focused role supporting web, email, social, digital advertising, and print deliverables. You'll work across multiple clients and industries, producing social graphics, paid ads, email designs, web mockups, landing pages, presentations, and print collateral. Candidates with agency or multiclient experience who enjoy switching between diverse tasks will excel in this role. You will collaborate closely with the Digital Strategy Team. Key Responsibilities - Create digital assets including social graphics, ad creative, email layouts, web wireframes, mockups, and presentations. - Support web and email...

CareFirst BlueCross BlueShield Resp & Qualifications We're hiring for a Lead Data Analyst - Value-Based Care Reporting on the Health Economics and Reporting team at CareFirst! 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 other business-related activities. We are not looking for generalists who may have an IT background and various credentials like Scrum, Agile, etc. 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....

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that govern the appeal process for Commercial and lines of business in order to formulate a professional response to the appeal request. 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: Investigates, interprets, and analyzes written appeals and reconsideration requests from multiple sources including applicants, subscribers, attorneys, group administrators, internal stake holders and any other...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that govern the appeal process for Commercial and lines of business in order to formulate a professional response to the appeal request. 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: Investigates, interprets, and analyzes written appeals and reconsideration requests from multiple sources including applicants, subscribers, attorneys, group administrators, internal stake holders and any other...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We are looking for a Business Analyst who has experience working in healthcare or a healthcare payor organization and experience with project management to 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 other business-related activities. In this position, the incumbent will be supporting all market segments of the Care Management Department and providing business and data analysis support while leading initiatives and managing projects to drive strategic impact. Demonstrated proficiency in Power BI, MS SQL Server, Excel and Tableau preferred. The Business Analyst will have the responsibility to ensure that the business's need for changes to processes, policies and/or information systems are identified, understood, defined, documented and acted upon by eliciting,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This role is primarily remote with occasional in office team meetings. Provides advanced expertise in developing and maintaining reports, dashboards and data repositories to meet the business intelligence requirements of the organization. Provides data, analysis and requirements in support of a complex reporting and analytics environment. Serves as a subject matter expert in projects related to the data analysis and reporting tools technology. ESSENTIAL FUNCTIONS: Fulfill complex regulatory reporting requirements by understanding the external request and working with IT and business resources to provide CareFirst data into mandated reporting within required timelines. Develops client/customer presentations and reports with a high degree of a more complex nature. May develop innovative best practices and industry bench marking for process measurement and identify indicators for future improvement...

Workday Your work days are brighter here. We're obsessed with making hard work pay off, for our people, our customers, and the world around us. As a Fortune 500 company and a leading AI platform for managing people, money, and agents, we're shaping the future of work so teams can reach their potential and focus on what matters most. The minute you join, you'll feel it. Not just in the products we build, but in how we show up for each other. Our culture is rooted in integrity, empathy, and shared enthusiasm. We're in this together, tackling big challenges with bold ideas and genuine care. We look for curious minds and courageous collaborators who bring sun-drenched optimism and drive. Whether you're building smarter solutions, supporting customers, or creating a space where everyone belongs, you'll do meaningful work with Workmates who've got your back. In return, we'll give you the trust to take risks, the tools to grow, the skills to develop and the support of a company...

American Red Cross Please use Google Chrome or Mozilla Firefox when accessing Candidate Home. By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spirit at its best. Are you ready to be part of the world's largest humanitarian network? Join us-Where your Career is a Force for Good! Job Description: Joining the American Red Cross is like nothing else - it's as much something you feel as something you do. You become a vital part of the world's largest humanitarian network. Joining a team of welcoming individuals who are exceptional yet unassuming. Diverse, yet uncompromising in unity. You grow your career within a movement that matters, where success is measured in people helped, communities made whole, and individuals equipped to never stop changing lives and situations for the better. When you choose to be a force for good, you'll have mentors who empower your growth along a purposeful career...

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. Summary of the Role: As a Client Advocate, you’ll be part of our client-facing team, responsible for addressing and resolving client and employee inquiries across a wide range of topics. Essential Duties and Responsibilities: Respond to and resolve customer service inquires and issues by identifying the topic and type of assistance the client needs such as benefits, eligibility and claims, financial spending accounts and correspondence. Help guide and educate clients and their employees about the fundamentals and benefits of their lines of...

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. Summary of Role: As a Benefits Coordinator you will have the opportunity to be part of a training class, learning the ins and outs of the Benefits industry. You will work closely with account teams, assisting with the day-to-day servicing of our clients. This is an amazing opportunity to start in an entry level role and grow with us! Essential Duties and Responsibilities Gains exposure to clients and carrier contacts; attends meetings and calls, may take an active role with clients Assist...

Aledade The Business Analyst, Payments is a critical member of the Payments Solutions team responsible for translating complex payment operations needs into clear, actionable technical and process requirements. This role will focus on accelerating data automations into QuickCap and the Corporate Cash Flow (CCF) / payments data stack, and eliminating manual handoffs between Payments, Finance, and Enterprise Applications. Additionally, this role will be a key contributor in a separate initiative to select and implement a second payment solution for non-claims-based payments. Working closely with the Senior Director, Payments Solutions, Corporate Systems (e.g., QuickCap, NetSuite), and Finance partners, the Business Analyst will design and document endtoend workflows, support data mapping and reconciliation requirements, and contribute to the delivery of scalable payment capabilities for over 20 different payment types that will help Aledade grow to $2B+ in annual practice...

CareFirst BlueCross BlueShield Resp & Qualifications CANDIDATES MUST LIVE IN THE DC/VA AREA IN ORDER TO TRAVEL FREQUENTLY INTO THE OFFICES AND TO ATTEND CLIENT MEETINGS. A CURRENT HEALTH AND LIFE LICENSE IS REQUIRED PURPOSE: This position is responsible for new business development within the Mid-Market space. This role leads sales initiatives and strategies as well as relationship building with both our external partners and prospects as well internal constituents. The sales consultant position requires a deep level of knowledge and understanding of selling to self-insured customers with complex benefit arrangements. In addition, the role requires having experience and excellent presentation skills in meeting with C-suite prospects as well large consultant practices. ESSENTIAL FUNCTIONS: Achieve sales goals and profitable growth for the organization. Position and sell multiple lines of coverage, medical, stop loss, dental and vision. Strategize on...

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...

CareFirst BlueCross BlueShield Resp & Qualifications The Data Analytics Intern role exists as a hiring strategy to bring in students enrolled in an accredited college or university who are pursuing at least a Bachelors degree in analytical and/or data visualization related fields to learn the business and technical side of healthcare from the ground up. Data and Analytics creates cutting edge analytic tools/visualizations to drive insights and faster decision making within the organization and provides critical support for key corporate initiatives. This role will require interaction with project stakeholders and business partners within the organization. This position will use analytically derived insights to develop and test solutions that enhance consumer engagement, improve health outcomes and reduce health care costs. This is a fast-paced, collaborative, and iterative environment requiring quick learning, agility and flexibility. This is a Year-Round Internship....

CareFirst BlueCross BlueShield Resp & Qualifications CareFirsts Strategic Growth division is accepting internship applications for our Summer 2026 program, spanning the companys marketing and communications, commercial sales, government programs, federal employee program, and strategic enablement functions.Through this internship program you will join a small team of driven, optimistic individuals seeking to improve healthcare - for our members and the world at large. Combining diverse backgrounds, viewpoints, life experiences, and skillsets we seek to be a proactive agent of meaningful change. We are not just reimagining healthcare for the future, we are actively transforming the way it is delivered, supported, and experienced today.We are looking for like-minded individuals who both share our mission of improving healthcare and remain humbled (if undaunted) by scale of the challenge. Whether your passion lies in distilling insights from data, crafting inspiring...