52 head of commercial markets jobs found in Baltimore, MD

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Director, Commercial Markets provides leadership for the operation of the Commercial Markets Individual programs across multiple jurisdictions, including strategic direction for the development and expansion the business, ensure the profitability, growth, and stability of the business. The Director will have responsibility for business direction, financial performance, growth strategy, product direction, and multi-year strategy necessary to deliver the overall strategic plan. Through collaboration with matrix leaders in marketing, finance, operations, health services and compliance, the Director will drive membership growth, financial performance, contractual compliance, and quality. ESSENTIAL FUNCTIONS: Business Planning Develop and oversee implementation of annual business plan and their components of the 3-year strategic plan. Establish the business objectives for all matrixed and direct...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Director, Commercial Markets provides leadership for the operation of the Commercial Markets Individual programs across multiple jurisdictions, including strategic direction for the development and expansion the business, ensure the profitability, growth, and stability of the business. The Director will have responsibility for business direction, financial performance, growth strategy, product direction, and multi-year strategy necessary to deliver the overall strategic plan. Through collaboration with matrix leaders in marketing, finance, operations, health services and compliance, the Director will drive membership growth, financial performance, contractual compliance, and quality. ESSENTIAL FUNCTIONS: Business Planning Develop and oversee implementation of annual business plan and their components of the 3-year strategic plan. Establish the business objectives for all matrixed and direct...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Director, Commercial Markets provides leadership for the operation of the Commercial Markets Individual programs across multiple jurisdictions, including strategic direction for the development and expansion the business, ensure the profitability, growth, and stability of the business. The Director will have responsibility for business direction, financial performance, growth strategy, product direction, and multi-year strategy necessary to deliver the overall strategic plan. Through collaboration with matrix leaders in marketing, finance, operations, health services and compliance, the Director will drive membership growth, financial performance, contractual compliance, and quality. ESSENTIAL FUNCTIONS: Business Planning Develop and oversee implementation of annual business plan and their components of the 3-year strategic plan. Establish the business objectives for all matrixed and direct...

GSK At GSK, we have bold ambitions for patients, aiming to positively impact the health of 2.5 billion people by the end of the decade. R&D is committed to discovering and delivering transformational vaccines and medicines to prevent and change the course of disease. Science and technology are coming together in a way they never have before, and we have strong tech-enabled capabilities that allow us to build a deeper understanding of the patient, human biology and disease mechanisms, and transform medical discovery. We are revolutionising the way we do R&D. We're uniting science, technology and talent to get ahead of disease together. Are you a driven and motivated regulatory affairs professional? As a Global Regulatory Affairs Manager at GSK, you will play a pivotal role in developing and executing global and regional regulatory strategies for our assets. Your efforts will ensure that our development programs meet the needs of key markets and align with the Medicines...

Site Name: USA - Pennsylvania - Upper Providence, USA - Maryland - Rockville, USA - Massachusetts - Waltham, USA - Pennsylvania - Philadelphia Posted Date: Oct 31 2024 Accountable to GRL and Global Regulatory TA Head for development of appropriate regional regulatory strategy(s) and for delivery according to plans. In conducting role, planning will be on a multiple year horizon, with delivery requiring extensive matrix working within GSK to VP level and representing GSK with at least the local regulatory agency. Work with the Early/Medicine Development Team (EDT/MDT) or GRL, to ensure a robust regulatory strategy is in place to support the development program to meet the needs of the key markets identified in the Integrated Asset plan and the Medicine Profile. Work closely with local / regional commercial team to secure best possible labelling commensurate with the available data. Lead interactions with local / regional regulatory authorities. Key Responsibilities:...

Site Name: USA - Pennsylvania - Upper Providence, Durham Blackwell Street, Rockville Vaccines, Waltham Posted Date: Nov 20 2024 At GSK, we have bold ambitions for patients, aiming to positively impact the health of 2.5 billion people by the end of the decade. R&D is committed to discovering and delivering transformational vaccines and medicines to prevent and change the course of disease. Science and technology are coming together in a way they never have before, and we have strong tech-enabled capabilities that allow us to build a deeper understanding of the patient, human biology and disease mechanisms, and transform medical discovery. We are revolutionising the way we do R&D. We’re uniting science, technology and talent to get ahead of disease together. Are you passionate about regulatory strategy and oncology? Within the Oncology space, we are in a period of very dynamic growth, as we continue to expand and develop our pipeline and portfolio. We are looking for a...

Site Name: USA - Pennsylvania - Upper Providence, Durham Blackwell Street, Rockville Vaccines, Waltham Posted Date: Nov 20 2024 At GSK, we have bold ambitions for patients, aiming to positively impact the health of 2.5 billion people by the end of the decade. R&D is committed to discovering and delivering transformational vaccines and medicines to prevent and change the course of disease. Science and technology are coming together in a way they never have before, and we have strong tech-enabled capabilities that allow us to build a deeper understanding of the patient, human biology and disease mechanisms, and transform medical discovery. We are revolutionising the way we do R&D. We’re uniting science, technology and talent to get ahead of disease together. As an Associate Director of Global Regulatory Affairs, you will ensure the development and execution of global and/or regional regulatory strategies for assigned assets. These strategies will be in alignment with...

CareFirst BlueCross BlueShield Resp & Qualifications Note: 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. PURPOSE: Leads the organization's efforts to achieve excellence in healthcare affordability, quality, member experience, and improved population and member outcomes in both commercial and government program lines of business. Through deep operational and clinical expertise, drives the company-wide Quality Management program (including CMS Stars and risk adjustment), and the ongoing development and implementation of health care policy and technology assessment. Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to...

CareFirst BlueCross BlueShield Resp & Qualifications CareFirsts Strategy & Growth division is accepting internship applications for our Summer 2025 program, spanning the companys venture capital, management consulting, marketing and communications, and strategic marketing 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 information campaigns,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process for members and providers who appeal on behalf of members for Commercial and Government Programs lines of business. Develops, evaluates and oversees the implementation of policies and procedures that result in quality resolution of member and provider disputes regarding adverse and adverse coverage determinations in accordance with Federal and State mandates. Directs the activities and serves as a resource for associates within the Clinical Appeals and Analysis unit. 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...

Lundbeck Territory: Baltimore North, MD - Psychiatry Target city for territory is Baltimore - will consider candidates who live within 40 miles of territory boundaries with access to a major airport. Territory boundaries include: Jarrettsville, Overlea, Milford Mill and Manchester. SUMMARY: Are you a results-driven biopharmaceutical sales professional looking to be part of an organization that values being a curious, adaptable and accountable? Lundbeck is a global biopharmaceutical company focusing exclusively on brain health. With more than 70 years of experience in neuroscience, we are committed to improving the lives of people with neurological and psychiatric diseases. Lundbeck employees are inspired and driven by our purpose to advance brain health and transform lives. Join us on our journey of growth! As a Psychiatry Account Manager, you lead the promotion of our psychiatry portfolio, executing sales and marketing strategies with comprehensive clinical...

CareFirst BlueCross BlueShield Resp & Qualifications *Candidates must live in the 21215, 21216, 21217 West Baltimore area. This position will be reporting in-person daily at our new location within The Village at Mondawmin * PURPOSE: Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications. ESSENTIAL FUNCTIONS: Provides first-level problem resolution to member, provider & broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: CareFirst is looking for a strong and innovative leader to oversee an insurance captive. This role is responsible for leading and overseeing the operations, strategy, and performance of CareFirsts insurance captive. The director plays a key role in captive strategy development and execution, ensuring effective captive operations, achieving financial goals, and complying with regulatory standards. This role actively identifies and pursues new market growth opportunities and works collaboratively to retain existing business and collaborates with internal and external partners on initiatives ESSENTIAL FUNCTIONS: Leads the development and execution of comprehensive strategies focusing on the Specialty business marketplace to ensure CareFirst has market leading products, strong preferred commercial vendor relationships and operational excellence to support future growth. Identifies, aggressively seeks...

CareFirst BlueCross BlueShield Resp & Qualifications This position is HYBRID with some travel requirements to the MD/DC offices a few times a month but could be more frequent at times. PURPOSE: The Formulary Clinical Pharmacist will perform comprehensive clinical services with a focus on formulary management of the commercial pharmacy benefit. Responsibilities will include but are not limited to: oversight of commercial formulary documents and custom coded drug lists, drug trend management, utilization management program monitoring including coverage criteria development/maintenance, and vendor oversight of delegated programs. This position will work in a matrixed environment across the organization. ESSENTIAL FUNCTIONS: Collaborates with internal teams and our Pharmacy Benefit Manger (PBM) to continuously ensure accuracy and compliance for all CareFirst commercial formulary documents, formulary change notifications, and custom coded drug lists for the...

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 and post claim medical review for Commercial, FEP and Medicare Advantage Plans. 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 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: Receives, researches,...

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 line of business in order to formulate a professional response to the appeal request. We are looking for an experienced professionals 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 DESCRIPTION: CareFirst is hiring for a Wellbeing Consultant to support both a large book of commercial business and well as being laser focused on a large multi-site client in the Maryland/DC Metropolitan area (school system providing wellbeing programs to the faculty and staff population at headquarters, schools, and other county locations). As a Wellbeing Consultant you will sit onsite with the client on average 4 days per week. You will be responsible for developing, implementing, coordinating, and facilitating activities and projects related to the clients workplace wellness strategy to improve the health and well-being of both employees and their families. PRINCIPAL ACCOUNTABILITIES: Develop Wellbeing strategy and Culture of Health goals to impact overall health. Development of wellness programs and communications plan designed to improve the health and well-being of the employee population....

Site Name: USA - Maryland - Baltimore, USA - Delaware - Wilmington, USA - Maryland - Baltimore East, USA - Maryland - Baltimore West, USA - Maryland - Salisbury Posted Date: Dec 23 2024 ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV. ViiV Healthcare is highly mission-driven in our unrelenting commitment to being a trusted partner for all people living with and affected by HIV. Our aim is to think, act, and connect differently through a focus on education on for the prevention and treatment for HIV. We go to extraordinary lengths to deliver the sorts of breakthroughs, both in prevention, treatments, care solutions and communities, that really count. We go beyond the boundaries of medicine by taking a holistic approach to HIV through developing and supporting sustainable community programs and improving access to care. We are fully committed to push...

Site Name: USA - Maryland - Baltimore, USA - Delaware - Wilmington, USA - Maryland - Baltimore East, USA - Maryland - Baltimore West, USA - Maryland - Salisbury Posted Date: Dec 23 2024 ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV. ViiV Healthcare is highly mission-driven in our unrelenting commitment to being a trusted partner for all people living with and affected by HIV. Our aim is to think, act, and connect differently through a focus on education on for the prevention and treatment for HIV. We go to extraordinary lengths to deliver the sorts of breakthroughs, both in prevention, treatments, care solutions and communities, that really count. We go beyond the boundaries of medicine by taking a holistic approach to HIV through developing and supporting sustainable community programs and improving access to care. We are fully committed to push...

Site Name: USA - Maryland - Baltimore Posted Date: Dec 13 2024 Territory to include but not limited to Baltimore Why join us? GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. We aim to positively impact the health of 2.5 billion people by the end of the of decade, as a successful, growing company where people can thrive. We are a focused biopharma company. We prevent and treat disease with vaccines, specialty and general medicines. We focus on the science of the immune system and advanced technologies, investing in four core therapeutic areas ( I nfectious D iseases, HIV, R espiratory , I mmunology and O ncology). Our Ahead Together strategy means intervening early to prevent and change the course of disease, helping to protect people and support healthcare systems. It’s an exciting time in GSK as we bring outstanding people together to do work that matters and impacts the...