CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The On-Site Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both case management and utilization management. To include proficiency in established guidelines to determine medical necessity, appropriate level of care, referrals to case management to engage members/enrollees, their families and other support systems in discharge planning. The role will function as a liaison onsite at a health system in Maryland with the hospital care team including case managers, social workers, and discharge planners to ensure CareFirst members/enrollees receive the appropriate level of care and partner to address any potential barriers to discharge. Occasional weekend work may be required. The candidate may also be required to come to the CareFirst office location periodically for meetings, training, or other...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The On-Site Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both case management and utilization management. To include proficiency in established guidelines to determine medical necessity, appropriate level of care, referrals to case management to engage members/enrollees, their families and other support systems in discharge planning. The role will function as a liaison onsite at a health system in Maryland with the hospital care team including case managers, social workers, and discharge planners to ensure CareFirst members/enrollees receive the appropriate level of care and partner to address any potential barriers to discharge. Occasional weekend work may be required. The candidate may also be required to come to the CareFirst office location periodically for meetings, training, or other...

CareFirst BlueCross BlueShield Resp & Qualifications The candidate may also be required to come to the CareFirst office location periodically for meetings, training, or other business-related activities. Bilingual - fluent in Spanish a big plus! PURPOSE: The Clinical Navigator (RN) manages the timely and smooth transition from inpatient care to home or other levels of care utilizing experience and skills in both care management and utilization management including proficiency in established guidelines to determine medical necessity, appropriate level of care, and case management to engage members/enrollees, their families and other support systems in discharge planning. The role will function as a liaison (onsite and/or telephonically; occasional weekend work may be required) with the hospital care team including case managers, social workers and discharge planners to ensure CareFirst members/enrollees receive the appropriate level of care and partner to address any...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Working as a bridge between the member, clinical and administrative staff, the Navigator helps members, families, and caregivers access the health care delivery system through outreach, follow-up, coordination support, education, communication, and resources. ESSENTIAL FUNCTIONS: Act as a liaison to ensure members are connected with appropriate care channels (i.e. pharmacy, insurance, billing, referral) and have the information they need to successfully navigate their care journeys. Outreach and follow-up with patients in between episodes of care as appropriate to promote a seamless and predictable healthcare experience. Ensure that member went to appointments and assist with coordination for transportation and pharmacy needs. Collect all information and relay to Care Coordination team. QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: 3 years community...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Working as a bridge between the member, clinical and administrative staff, the Navigator helps members, families, and caregivers access the health care delivery system through outreach, follow-up, coordination support, education, communication, and resources. ESSENTIAL FUNCTIONS: Act as a liaison to ensure members are connected with appropriate care channels (i.e. pharmacy, insurance, billing, referral) and have the information they need to successfully navigate their care journeys. Outreach and follow-up with patients in between episodes of care as appropriate to promote a seamless and predictable healthcare experience. Ensure that member went to appointments and assist with coordination for transportation and pharmacy needs. Collect all information and relay to Care Coordination team. QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: 3 years community...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Working as a bridge between the member, clinical and administrative staff, the Navigator helps members, families, and caregivers access the health care delivery system through outreach, follow-up, coordination support, education, communication, and resources. ESSENTIAL FUNCTIONS: Act as a liaison to ensure members are connected with appropriate care channels (i.e. pharmacy, insurance, billing, referral) and have the information they need to successfully navigate their care journeys. Outreach and follow-up with patients in between episodes of care as appropriate to promote a seamless and predictable healthcare experience. Ensure that member went to appointments and assist with coordination for transportation and pharmacy needs. Collect all information and relay to Care Coordination team. QUALIFICATIONS: Education Level: High School Diploma or GED Experience: 3 years community...

CareFirst BlueCross BlueShield Resp & Qualifications *Applicants Must Reside in One of The Following ZIP CODES: 21215, 21216, 21217 PURPOSE: This position will support the Maryland government programs division, working as a bridge between the member, clinical and administrative staff. The Navigator helps members, families, and caregivers access the health care delivery system through outreach, education, follow-up, coordination support, and resources. Outreach includes both telephonic and community-based outreach, including home-visits with our members. We are looking for an experienced professional to work remotely within Baltimore and surrounding region. While this position is remote, the incumbent will be expected to come into a CareFirst location periodically for meetings, trainings and/or other business-related activities, in addition to traveling throughout the community they serve to support our members. In addition, the Community Health Navigator...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Service Navigator at the CareFirst Community Engagement Center in West Baltimore is responsible for resolving all customer inquiries via phone, walk-ins, email, and in the greater community. These inquiries may pertain to benefits, claim payments, or enrollment support. The specialist is expected to respond professionally, efficiently, and promptly to enhance member and customer satisfaction. ESSENTIAL RESPONSIBILITIES: Top-Level Service : Provides exceptional service to members and business partners, always responding in a professional and timely manner to enhance member satisfaction and retention. Documentation and Interpretation : Documents, research, and interprets internal and external customer needs concerning our products, services, and policies. Flexibility and Ownership : Demonstrates a willingness to adapt and be flexible to the changing needs of the business while taking ownership to...

National Institutes of Health Job Summary The National Institute of Neurological Disorders and Stroke (NINDS) is a leading supporter of biomedical research on disorders of the brain and the nervous system at the National Institutes of Health (NIH). NINDS leads two major trans-NIH programs to support early translational efforts in therapeutics discovery and development - Blueprint Neurotherapeutics Network (BPN) and Pain Therapeutics Development program (PTDP) to advance the NIH mission and therapeutics discoveries towards clinical trials and ultimately patient use. Located within the Division of Translation Research (DTR), the Director, Biologics and Biotherapeutics Development is intended to oversee the BPN Biologics Program and the Ultra-rare Gene-based Therapy (URGenT) Network to create significant synergy and efficiently accelerate therapeutics development designed to prevent and treat CNS disorders and is focused on the academic and small business community and...

Capital One Center 2 (19050), United States of America, McLean, Virginia Sr. Director, Chief of Staff - ITE Program Operations Capital One is committed to investing in international markets to broaden our access to high quality tech talent. Our multi-year goal is to grow Capital One's international talent footprint to be 5000+ people by 2030. This longer term goal is both ambitious and critical to the continued growth and success of meeting the talent needs of Capital One. Our immediate areas of focus are on launching our new Mexico City location, scaling India in alignment with our growth strategy, and analyzing options to expand our existing footprint in India and Canada. In two years we've made meaningful progress to establish the foundations for this ambitious agenda. General Responsibilities: As a Sr. Director, Program Operations Lead, you'll establish and lead the central tower for ITE operations (command center) for our global talent expansion program. This...

Aledade The Care Manager will work with Aledade primary care practices in Maryland as a part of the Maryland Primary Care Program. The care manager collaborates with the care team within each practice and leverages Aledade's interdisciplinary care team to provide telephone-based health coaching, quality improvement, and care coordination. The care manager works closely with Medicare patients to support them in becoming active in their health care by better understanding their chronic conditions, helping them access care in the most appropriate setting, and improving quality of care. Care managers utilize Aledade's proprietary population health tool, the "Aledade App" to manage high-risk patients, using real-time data to identify and intervene on high utilizers who could benefit from more preventative and active management. Primary Duties: Conduct comprehensive assessments that include the medical, behavioral, pharmaceutical and social needs of the patient, identify and...