17 job progression jobs found

Kaiser Permanente Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission. Essential Responsibilities: Completes an initial face-to-face assessment for every admitted member to identify discharge needs within 24hrs of admission. Document in KPHC and communicate the assessment outcomes to determine the appropriate transition plan with MAPMG physician healthcare team and patient/family. Active participant in daily Care Without...

Open Systems Technologies Corporation Open Systems Technologies Corporation is a leader in the government contracting marketplace, providing Enterprise Security and Cloud Computing solutions to support large organizations. Our capabilities include supplying federal government entities and private businesses with software development, scientific and engineering technical assistance, systems integration, and enterprise security. Since its founding in 1996, OST has been committed to delivering high-quality, best-in-class results that bring added value to our clients while investing in our employees’ futures by providing exciting projects to work on, and robust benefits to include technical training and certifications, relocation assistance and a 401K match with immediate vesting. Open Systems Technologies is seeking a Solution Train Engineer to support a nationally significant and fast-paced program. An experienced, energetic Solution Train Engineer (STE) is needed to...

ALDI When you join our team as an Assistant Store Manager, you'll take on key store management responsibilities including assisting with supervising day-to-day store activities, ensuring overall store performance, managing schedules, and developing operational action plans while identifying training opportunities to develop and grow the team. Position Type: Full-Time Average Hours: 38 hours per week Starting Wage: $27.50 per hour Wage Increase: Year 2 - $28.50 per hour Duties and Responsibilities: Must be able to perform duties with or without reasonable accommodation * Assists the direct leader with developing and implementing action plans to improve operating results * Establishes and communicates job responsibilities and performance expectations to their direct reports to ensure mutual understanding and desired results * Identifies training and development opportunities that will assist their direct reports in achieving enhanced performance * Understands the...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Risk Adjustment Supervisor supports the execution of the corporate risk adjustment strategy across Medicare Advantage, Medicaid, and ACA markets. This role ensures operational compliance by supervising day-to-day activities, monitoring performance metrics, and facilitating cross-functional collaboration to drive cost-effective risk adjustment actions and optimize health plan performance to achieve equitable resource allocation based on population health risk profiles. This role is also responsible for overseeing the accurate collection, submission, and validation of risk adjustment data, ensuring compliance with regulatory standards and optimizing organizational performance under various risk adjustment programs. 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...

Transamerica Job Family Operational Risk About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment - one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we're part of an international holding company, with millions of customers and thousands of employees...

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...

Aledade The Research Analyst will support Aledade business goals with analyses that leverage rich data sources including national Medicare claims, other payer claims, electronic health records, and event notification data. Develop and maintain documentation and reporting frameworks to ensure transparency, reproducibility, and compliance with internal and external standards. Provide subject matter expertise in risk analytics, offering insights and recommendations to partners within the broader Impact Analytics team. Work cross-functionally with partners across actuary, product and engineering organizations to drive insights. Primary Duties Understand the problem space: Work with teams across Aledade and external partners to understand and clarify questions and issues for data analysis and experiments. Assist in analysis execution: Design descriptive statistical analyses to answer key business questions. Design and program code to integrate, evaluate, and...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Senior Business Analyst will have the responsibility to ensure that the Medicare Pharmacy business's need for changes to processes, policies and/or information systems are identified, understood, defined, documented and acted upon by eliciting, analyzing, documenting, validating, specifying and verifying the needs of business or user. The incumbent is accountable for the gathering and synthesizing of business requirements for moderate complexity software, systems, processes and/or services and translates them into specifications ensuring the business objectives are met. As the functional expert, the incumbent serves as a strategic conduit between the business area and the technical or software development team through which requirements flow. ESSENTIAL FUNCTIONS: Interprets Medicare Pharmacy business needs and issues by gathering, eliciting, creating, analyzing, documenting and validating the...

Aledade The Senior Salesforce Technical Project Manager leads enterprise-level Salesforce delivery initiatives across Salesforce Sales Cloud, Service Cloud and their associated integrations. This role requires a strong mix of technical delivery leadership, project/program management, and cross-system integration oversight, with an emphasis on MuleSoft-driven API-led connectivity. This position acts as the bridge between business stakeholders, Salesforce engineering teams, integration architects, and external system vendors. You will plan, coordinate, and manage complex technical implementations, guide solution design discussions, and ensure delivery quality through structured Agile methodologies, CI/CD governance, and best-practice architecture patterns. The Senior Salesforce Technical Project Manager provides end-to-end oversight across technical design, development, testing, deployment, and stabilization-ensuring predictable, high-quality outcomes for a...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: We're hiring for a Manager, Data Analytics - Value-Based Care Reporting on the Health Economics and Reporting team at CareFirst! Purpose of the Manager, Data Analytics is to execute business objectives with data and ensure alignment with the vision of the company. Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction. 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...

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...

CareFirst BlueCross BlueShield Resp & Qualifications We're hiring for a Manager, Data Analytics - ID/STRAT and Program Evaluation on the Health Economics and Reporting team at CareFirst! Over the last few years, we have been busy building the capacity for broader Cost of Care management at CareFirst, and for 2026 and beyond, we are looking for individuals that can help in a variety of analytic domains to act as a "force multiplier" and enable our Health Services team and broader enterprise with the data and insights needed to build better programs and operations at our plan. PURPOSE: Purpose of the Manager, Data Analytics is to execute business objectives with data and ensure alignment with the vision of the company. Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Manage the Sales Compensation and Broker Administration teams responsible for processing internal sales incentives, administering broker contracts and compensation programs, and delivering sales reporting and forecasting analysis. This role ensures accurate and timely execution of compensation and incentive programs, maintains operational excellence, and provides analytical insights to support sales force effectiveness and business decision-making. ESSENTIAL FUNCTIONS: Team Leadership & Development: Supervise and develop the Sales Compensation and Broker Administration teams, including hiring, onboarding, training, and performance management. Set clear performance expectations, provide regular coaching and feedback, and conduct performance reviews. Foster a collaborative team environment focused on accuracy, timeliness, and customer service. Develop team member capabilities through training on...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Manage the Sales Compensation and Broker Administration teams responsible for processing internal sales incentives, administering broker contracts and compensation programs, and delivering sales reporting and forecasting analysis. This role ensures accurate and timely execution of compensation and incentive programs, maintains operational excellence, and provides analytical insights to support sales force effectiveness and business decision-making. ESSENTIAL FUNCTIONS: Team Leadership & Development: Supervise and develop the Sales Compensation and Broker Administration teams, including hiring, onboarding, training, and performance management. Set clear performance expectations, provide regular coaching and feedback, and conduct performance reviews. Foster a collaborative team environment focused on accuracy, timeliness, and customer service. Develop team member capabilities through training on...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Purpose of the Manager, Data Analytics is to execute business objectives with data and ensure alignment with the vision of the company. Individual will organize the technology, processes and financial resources necessary to address the current and future analytics needs of the business. Provides thought leadership and acts as a subject matter expert in the designing and recommending of appropriate analytical approaches and methodologies. Provides management responsibility into data-driven insights that inform the business's strategic direction. 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 a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week. We are not looking for...

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: 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...