Oversee engagement of federal government officials and their staffs on behalf of CareFirst to ensure that the Companys position is considered in legislative and regulatory decisions and that ...
Oversee engagement of federal government officials and their staffs on behalf of CareFirst to ensure that the Companys position is considered in legislative and regulatory decisions and that ...
Responsible for the CareFirst provider agreement templates used to contract all providers in one or many networks. Identifies and implements opportunities to improve workflows, drive administrative ...
Responsible for the CareFirst provider agreement templates used to contract all providers in one or many networks. Identifies and implements opportunities to improve workflows, drive administrative ...
As the corporate venture, development, and commercialization arm of CareFirst BlueCross BlueShield, Healthworx is building a portfolio of investments and strategic partnerships with forward-thinking ...
As the corporate venture, development, and commercialization arm of CareFirst BlueCross BlueShield, Healthworx is building a portfolio of investments and strategic partnerships with forward-thinking ...
Working with CareFirst personnel to ensure specialty product, capabilities and market delivery is industry leading. This includes working with various CareFirst areas to align the specialty offerings ...
Working with CareFirst personnel to ensure specialty product, capabilities and market delivery is industry leading. This includes working with various CareFirst areas to align the specialty offerings ...
Provide interpretation of regulations and regulatory rules/guidelines to demonstrate CareFirst BCBS and its subsidiaries' compliance with state and federal standards. Review and analyze all data ...
Provide interpretation of regulations and regulatory rules/guidelines to demonstrate CareFirst BCBS and its subsidiaries' compliance with state and federal standards. Review and analyze all data ...
Provides communication, education, issue/dispute resolution and support of managing all of CareFirst's contracted in-network providers including independent professional practices, health systems ...
Provides communication, education, issue/dispute resolution and support of managing all of CareFirst's contracted in-network providers including independent professional practices, health systems ...
Provides communication, education, issue/dispute resolution and support of managing all of CareFirst's contracted in-network providers including independent professional practices, health systems ...
Provides communication, education, issue/dispute resolution and support of managing all of CareFirst's contracted in-network providers including independent professional practices, health systems ...
Works with external stop-loss vendors to secure quotes for new TPA and CareFirst business. Analyzes census data, shock reports and claims history for current TPA and CareFirst groups to evaluate ...
Works with external stop-loss vendors to secure quotes for new TPA and CareFirst business. Analyzes census data, shock reports and claims history for current TPA and CareFirst groups to evaluate ...
Working in close collaboration with CareFirst clinical, analytics, and operations subject matter experts, the incumbent supports achievement of valuebased program goals while strengthening provider ...
Working in close collaboration with CareFirst clinical, analytics, and operations subject matter experts, the incumbent supports achievement of valuebased program goals while strengthening provider ...
The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns ...
The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns ...
The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns ...
The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's commercial and government value-based programs to understand patterns ...
Working from a home-base and traveling through the Western Maryland, the incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related ...
Working from a home-base and traveling through the Western Maryland, the incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related ...
Navigator, Community Health I (Hybrid)
Baltimore, MD · Remote
$19.50 - $25.75/hr
While this position is remote, the incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities, in addition to traveling ...
Navigator, Community Health I (Hybrid)
Baltimore, MD · Remote
$19.50 - $25.75/hr
While this position is remote, the incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities, in addition to traveling ...
Build trusted relationships within CareFirst to deepen subject-matter expertise, find opportunities to synchronize with core operations, and ensure close coordination with the central team in the ...
Build trusted relationships within CareFirst to deepen subject-matter expertise, find opportunities to synchronize with core operations, and ensure close coordination with the central team in the ...
Legal Clerk (Hybrid)
Baltimore, MD · Hybrid
Estimate Amount: 10% Legal clerks may be required to travel to CareFirst office locations other than their assigned office or to attend off-site meetings or events. Office of Corporate Counsel face ...
Legal Clerk (Hybrid)
Baltimore, MD · Hybrid
Estimate Amount: 10% Legal clerks may be required to travel to CareFirst office locations other than their assigned office or to attend off-site meetings or events. Office of Corporate Counsel face ...
This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the ...
This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the ...
This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the ...
This role will credential practitioners for network participation with CareFirst BlueCross BlueShield and accurately maintain all provider data within the enterprise-wide Provider file to supply the ...
Payment Policy Manager (Hybrid)
Baltimore, MD · Hybrid
$107K - $115K/yr
The Payment Policy Manager will ensure that CareFirst maintains accurate, compliant, and financially sound payment policies to support consistent claims adjudication and a value-based health care ...
Payment Policy Manager (Hybrid)
Baltimore, MD · Hybrid
$107K - $115K/yr
The Payment Policy Manager will ensure that CareFirst maintains accurate, compliant, and financially sound payment policies to support consistent claims adjudication and a value-based health care ...
The VP, Treasury & Investment Management is responsible for the leadership and oversight of the CareFirst's Treasury and Investments function including collaboration with the Lead Asset Manager to ...
The VP, Treasury & Investment Management is responsible for the leadership and oversight of the CareFirst's Treasury and Investments function including collaboration with the Lead Asset Manager to ...
The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: * Construct Excel spreadsheets and ...
The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities. ESSENTIAL FUNCTIONS: * Construct Excel spreadsheets and ...
Carefirst information
What are the key skills and qualifications needed to thrive in the Carefirst position, and why are they important?
To thrive in a Carefirst role, you need a background in healthcare or caregiving, excellent organizational skills, and a compassionate approach to client support, typically supported by relevant certifications such as CPR or first aid. Familiarity with care management software, scheduling tools, and basic medical documentation systems is often required. Outstanding interpersonal communication, patience, and problem-solving abilities help you build trust and respond effectively to clients' and families' needs. These skills are crucial for providing high-quality, client-centered care and ensuring smooth coordination among care teams.
What is a Carefirst job?
A Carefirst job typically refers to a position within CareFirst BlueCross BlueShield, a healthcare insurance company. Roles vary across departments like customer service, claims processing, IT, and healthcare management. Employees work to support healthcare services, process claims, and assist members with their insurance needs. Job requirements depend on the specific role, but they generally involve healthcare knowledge, customer service skills, and administrative expertise.
What does a typical day look like for someone working in a Carefirst position?
A typical day in a Carefirst role may involve assisting clients with daily activities such as meal preparation, medication reminders, and personal care tasks, while also documenting progress and any changes in condition. You’ll often collaborate closely with healthcare professionals, families, and other caregivers to ensure that each individual’s care plan is properly implemented. Because every client’s needs are unique, flexibility and adaptability are key, and you may need to shift your focus throughout the day. Many Carefirst professionals find this work highly rewarding, as it allows them to make a visible and positive difference in clients’ quality of life.
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Retirement
Posted 11 days ago
CareFirst BlueCross BlueShield rating
7.3
Based on 31 frontline employees who took The Breakroom Quiz
233rd of 299 rated insurance
Job description
Resp & Qualifications
PURPOSE:
This position is responsible for overseeing the development and execution of Federal legislative, regulatory and stakeholder relationship building and advocacy; the development of regulatory
responses, policy positions, legislative testimony, position papers and communications on key policy issues in collaboration with CareFirst's State Government Affairs team and other CareFirst
executives; monitoring and analyzing healthcare policy issues at the federal and state levels and creating and supporting public affairs campaigns in support of CareFirst's local, federal, and state policy positions in partnership with CareFirst's Public Relations and State Government Affairs teams, and other enterprise-wide executives to advance legislative, regulatory, and other advocacy campaigns.
ESSENTIAL FUNCTIONS:
Federal Relationships and Advocacy:
- Oversee engagement of federal government officials and their staffs on behalf of CareFirst to ensure that the Companys position is considered in legislative and regulatory decisions and that legislation and regulations introduced or amended are consistent with CareFirst policy and objectives. Enhance and solidify effective working relationships with legislators, regulators, opinion leaders, and various constituencies and community groups including but not limited to HHS/CMMI and CMS; DOL, WH, and Capitol Hill.
- Oversee coordination of CareFirsts positions relating to federal legislation and regulations. Research, develop and articulate positions on a wide variety of public policy issues affecting the Company. Advise senior management on federal legislators and regulators points of view and the effects of proposed laws and regulations on CareFirst.
- Establish and implement proactive strategies to promote CareFirsts legislative and policy agenda including managing contract lobbyists on the federal level, building coalitions necessary to influence legislation, regulation and policy positions that are consistent with CareFirsts goals and mission or avoiding legislative and regulatory threats
- Function as liaison with BCBSA, AHIP, and other trade associations on policy and federal legislative issues. Communicates CareFirsts opinions and positions within BCBSA and AHIP.
Policy Strategy, Analysis, and Communications:
- In consultation with the State Government Affairs team and leadership of the Company, advises and articulates the public policy agenda of the Company and develops strategy and communications to support this policy agenda.
- Drafts position papers and correspondence as well as written and verbal testimony for presentation before legislative and regulatory bodies.
- Research policy positions taken by other plans, BCBSA, competitors and trade groups and reconciles CareFirst positions, as appropriate.
- Works with external issues management consultants and external lobbyists to effectively and positively position the Company on complex issues of public policy.
- Oversees management of sensitive corporate issues (especially those with political implications), including anticipating issues that could affect the image and reputation of the Company, develop recommendations and articulating appropriate responses.
- Oversees development, publication and distribution of external reports to key stakeholders, including regulators, legislators and other relevant groups.
- Mobilizes other communications and policy resources to support timely communication of the Companys news and positions to key audiences, including legislators and regulators.
Management of Public Policy and Government Affairs Team:
- With the Vice-President of State Government Affairs, efficiently and effectively manages the CareFirst Public Policy and Government Affairs team. Sets strategic goals and direction, manages team and individual performance, manages budgets and salary, manages appropriate reporting, manages the development of team members and team leaders.
- Oversees the management and compliance of the CareFirst employees Political Action Committees.
SUPERVISORY RESPONSIBILITY:
- This position manages people.
QUALIFICATIONS:
Education Level: Bachelor's Degree in Healthcare Policy, Healthcare law or related business field.
Experience: 10 to 15 years of related experience, and 8 to 10 years of increasingly responsible management experience. Understanding and experience with state and federal regulatory legislative process with a particular focus on Medicaid and Medicare Advantage also highly desired. Autonomy in job experiences and prior experience in managing and collaborating with senior executives of diverse expertise and responsibilities is necessary. Strong relationships with representatives of key federal agencies including HHS is preferred.
Preferred Qualifications:
- A variety of experiences in healthcare policy is desirable.
- Advanced degree MPH or Juris Doctorate desired.
Knowledge, Skills and Abilities (KSAs)
- In-depth knowledge and experience with planning, writing, and editing.
- In-depth communications skills necessary. Well-developed organizational and monitoring skills to enhance functioning across a diverse organization.
- Ability to coordinate multiple public policy activities within a dynamic environment.
- Proven ability to communicate to diverse audiences through a variety of methods.
- Strong ability to work with senior management and with their full confidence.
- Ability to tap into a variety of resources to enhance the Companys image.
- High tolerance for ambiguity. Skilled in word processing (Microsoft Word), PowerPoint and internet research.,
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range: 235,520 - 353,280
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
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