CareFirst BlueCross BlueShield: Provides health insurance coverage and administrative healthcare services.
5+ YOE1+ MgmtActive RN state licensure, 5+ years care management experience, 1+ year supervisory experience, Bachelor\u0002s in Nursing or equivalent additional experience, Medicaid program knowledge, analytics and HEDIS familiarity.
MedStar Health: Providing comprehensive healthcare services and patient care.
3+ YOERegistered Nurse licensed in Maryland, ADN required (BSN preferred), 3+ years experience including ≥1 year case management, CCM preferred, valid in-state driver\u0000s license, EMR and Microsoft Word/Excel proficiency, strong communication and analytical skills.
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
Active Maryland RN license required; knowledge of managed care, discharge planning, utilization management, strong communication and analytical skills, ability to use hospital case management software.
Smith & NephewLondon Stock Exchange: SN: Develops medical equipment for tissue repair, regeneration, and replacement.
2+ YOEBachelor's degree or equivalent experience, 2+ years of B2B, direct selling, or medical sales experience, strong analytical and presentation skills, and complex sales process experience.
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
2+ YOEMaryland RN or equivalent healthcare license required; two years of acute-care hospital experience preferred. Requires case-management knowledge, strong communication, analytical, collaboration, and prioritization skills.
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
3+ YOEBachelor’s degree in nursing, current Maryland RN license, and 3 years of care coordination experience required. Acute care experience preferred; strong communication, analytical, teamwork, and care coordination skills required.
Director of Value-Based Care and Clinical Transformation (674240)
Hanover, Maryland, United States
$49-$78/hrHybridFull Time
Johns Hopkins Health System: Provides clinical care, medical research, and health education services.
10+ YOEBachelor's degree in business, finance, healthcare administration, or a clinical field; 10+ years of progressive healthcare experience, including value-based care models and strong financial and analytical skills.
Lead Charges and Claims Specialist (Chesapeake Specialty Care)
Annapolis, Maryland, United States
$44k-$66k/yrOnsiteFull Time
University of Maryland Faculty Physicians: Manages clinical and administrative operations for university faculty physicians.
4+ YOE1+ MgmtHigh school diploma required; 4–5 years medical billing and claims experience; 1–2 years leadership preferred. Requires payer, coding, denial management, EHR, analytical, communication, and organizational skills.
CPT, HCPCS, ICD-10, practice management systems, clearinghouses, EHR, Microsoft Word, Microsoft Excel, Microsoft Outlook
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
Active Maryland RN licensure (or compact eligibility) required; utilization/case management and acute care experience preferred; CPUR preferred; strong communication and analytical skills.
Johns Hopkins Health System: Provides comprehensive clinical healthcare and hospital medical services.
3+ YOEHigh school diploma and 3+ years in provider office, healthcare administration, managed care, or related healthcare environment. Requires accurate data entry, database proficiency, analytical skills, and communication skills.
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
3+ YOEBachelor's in Finance/Accounting required (or equivalent Decision Support experience); minimum 3 years financial/FP&A/ budgeting/managed care experience; working knowledge of decision support and financial software; strong communication and analytical skills.
Pathways Decision Support Product, Lotus, Microsoft Excel, DBASE, Microsoft Access, Microsoft Word