17 technical consultant jobs found

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: This entry level position is responsible for the attainment, effective management, and profitability of a designated book of business. This position utilizes underwriting judgment and exercises a level of authority. Pricing concessions are permitted up to the designated level of authority without further review. This position works closely with Sales and Account Management to ensure that client needs are met ESSENTIAL FUNCTIONS: Works closely with the Account Manager and Underwriting Manager to provide alternate benefit plans, risk and/or funding arrangements. Update appropriate billing rate files, contracts, internal databases, etc. Complete the renewal process on smaller accounts, complete/update ASO and Stop Loss contracts and quote alternate funding arrangements with assistance from senior underwriter, consultant or management. Support attainment of corporate sales and profitability goals...

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...

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 PURPOSE: To support the prevention, reduction of and/or recuperation of losses to CareFirst through the clinical review of medical records and claims, resulting in the savings and/or recovery of funds. Responsible for providing clinical knowledge to the SI team to support both prepayment reviews and/or post-payment investigations. ESSENTIAL FUNCTIONS: Review of medical records and claims. Investigate potential fraud and over-utilization by performing complex medical reviews of claims and medical records. The claims may be in a pre or post payment environment. Provide a detailed but concise analysis to communicate findings about the ability to pay or deny a claim or claim lines using clinical and/or coding, billing, or reimbursement knowledge. Maintain appropriate records and supporting documentation regarding findings in accordance with departmental standards. Process all assigned claims or batch case reviews...

Apex Systems, Inc. Job#: 3026290 Job Description: Systems Administrator (All Levels) - TS/SCI w/ Full Scope Polygraph (FSP) Location: Linthicum, MD / Annapolis Junction, MD Work Model: 100% On-Site (classified environment; not remote) Clearance: Active TS/SCI with Full Scope Polygraph (FSP) required (must be active/current) Employment Type: Contract We're seeking Systems Administrators (multiple levels) to support mission-critical classified environments for a large DoD integrator. You'll help design, deploy, secure, sustain, and troubleshoot Windows and/or Linux systems, often in virtualized (VMware) on-prem environments. Work includes partnering closely with network, security, software, and program teams to maintain high availability and compliance. Leveling note: This posting is intended to source multiple skill levels (Junior through Principal/SME). Final level/title aligns to experience and technical depth. What You'll Do...

Apex Systems, Inc. Job#: 3014544 Job Description: Title: ID Badge Specialist, Department of Public Safety IT, Johns Hopkins University Locations: Various locations in Baltimore City and the greater Baltimore metropolitan region to include: Johns Hopkins Hospital, JHU School of Medicine, Bloomberg School of Public Health, Bayview Medical Center, Howard County Medical Center, Johns Hopkins Greenspring Station Duration: Multiyear Description: As an ID Badge Coordinator reporting to the Manager - Card Services, you will assist in administering the employee identification process on behalf of Public Safety IT at assigned locations on Johns Hopkins campuses. Your role is crucial in maintaining a customer-oriented experience. The ideal candidate enjoys task-oriented work and thrives in a fast-paced environment with a diverse body of customers, with an acknowledged comfort in a patient care environment if assigned to a medical environment....

PerkinElmer Responsibilities Location Annapolis, Maryland US Job ID REQ-056953 This is a full-time position with Project Farma , a PerkinElmer company. The Senior Manager, PF Project Delivery is responsible forthe technical performanceof projectcontrols (scope,cost, schedule,andriskmanagement)andthebusiness developmentexpansion of services at partner accounts.In this billable client facing role,they willidentify,train,develop, coach, andmentortechnicalteamsdeveloping high performing project engineers and consultants.The Senior Manageris responsible forclientrelationship management and acts as client liaison during delivery ofmanufacturing solutionservices engagements.They are strategically focused and responsible for client satisfactionthroughproject deliverywhilemaintainingand growingclient relationships. In thisclient-facingrole, the SeniorManager will be able toidentifyadditionalopportunities to providenew andaddedservices for themutualbenefit oftheclient andthe...

Rentokil North America Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period! For more information about our benefits, see below! We are proud to be a member of the Rentokil family of companies, the global leader in Pest Control and other services across more than 90 countries. We pride ourselves on being a trusted partner to many of the world's leading brands and serve consumer and business customers across multiple industries. We are extremely proud of our legacy of excellence and constantly work to fulfill our mission to "protect people, enhance lives, and preserve the planet." What do our Pest Control Consultants do? The primary purpose of this role is to sell the company's industry leading pest management services and products to new and existing residential customers, while maintaining a customer-focused service to grow the business. You'll be the face of our national brand to your local community, and your clients will count on you to protect...

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: Responsible for the attainment, effective management, and profitability of a designated book of business. This position utilizes underwriting judgment and exercises a level of authority. Pricing concessions are permitted up to the designated level of authority without further review. This position works closely with Sales and Account Management to ensure that client needs are met without compromising the corporate objectives. This position is responsible for monitoring financial performance and apprising management as needed. Responsibilities also include pharmacy related underwriting functions, such as evaluating pharmacy benefit structures, reviewing high-cost drug utilization and trends, assessing risk tied to specialty medications, and collaborating with Pharmacy Benefits Management (PBM) partners to ensure appropriate pricing, risk mitigation, and compliance. ESSENTIAL FUNCTIONS: Ensure the...

Ehrlich Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period! For more information about our benefits, see below! We are proud to be a member of the Rentokil family of companies, the global leader in Pest Control and other services across more than 90 countries. We pride ourselves on being a trusted partner to many of the world's leading brands and serve consumer and business customers across multiple industries. We are extremely proud of our legacy of excellence and constantly work to fulfill our mission to "protect people, enhance lives, and preserve the planet." What do our Pest Control Consultants do? The primary purpose of this role is to sell the company's industry leading pest management services and products to new and existing residential customers, while maintaining a customer-focused service to grow the business. You'll be the face of our national brand to your local community, and your clients will count on you to protect their homes and...

Ehrlich Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period! For more information about our benefits, see below! We are proud to be a member of the Rentokil family of companies, the global leader in Pest Control and other services across more than 90 countries. We pride ourselves on being a trusted partner to many of the world's leading brands and serve consumer and business customers across multiple industries. We are extremely proud of our legacy of excellence and constantly work to fulfill our mission to "protect people, enhance lives, and preserve the planet." What do our Pest Control Consultants do? The primary purpose of this role is to sell the company's industry leading pest management services and products to new and existing residential customers, while maintaining a customer-focused service to grow the business. You'll be the face of our national brand to your local community, and your clients will count on you to protect their homes and...

Rentokil North America Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period! For more information about our benefits, see below! We are proud to be a member of the Rentokil family of companies, the global leader in Pest Control and other services across more than 90 countries. We pride ourselves on being a trusted partner to many of the world's leading brands and serve consumer and business customers across multiple industries. We are extremely proud of our legacy of excellence and constantly work to fulfill our mission to "protect people, enhance lives, and preserve the planet." About Comprehensive Food Safety (CFS) Comprehensive Food Safety is a leading provider of consulting, auditing, and training solutions tailored for the dynamic food industry. We partner with regional and national accounts-from food processing plants and retail establishments to distributors-to navigate complex regulations and business needs. Our team consists of highly skilled,...

Terminix Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period! For more information about our benefits, see below! We are proud to be a member of the Rentokil family of companies, the global leader in Pest Control and other services across more than 90 countries. We pride ourselves on being a trusted partner to many of the world's leading brands and serve consumer and business customers across multiple industries. We are extremely proud of our legacy of excellence and constantly work to fulfill our mission to "protect people, enhance lives, and preserve the planet." What do our Pest Control Consultants do? The primary purpose of this role is to sell the company's industry leading pest management services and products to new and existing residential customers, while maintaining a customer-focused service to grow the business. You'll be the face of our national brand to your local community, and your clients will count on you to protect their homes and...

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: 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...

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...