Top 30 Claims program manager Jobs in Baltimore, Md

Pharmacy Program Manager (Hybrid)
CareFirst BlueCross BlueShield —Baltimore, MD
- $106,632 - $211,783 a year
- Full-time
- Master's degree
- Analysis skills
- Bachelor's degree
- 401(k)
Quick Apply
Fleet Safety Manager ( Commercial Electrical)
Baird Consulting Group —Cockeysville, MD
- $80,000 - $130,000 a year
- Full-time
- CPR Certification
- Clean driving record
- OSHA
- Paid holidays
- Health insurance
Quick Apply
10d
Program Manager/Training Lead
Contact Government Services, LLC —Baltimore, MD
- $180,000 - $200,000 a year
- Full-time
- 5 years
- Mid-level
- Supervising experience
- Health insurance
- Dental insurance
Quick Apply
Senior Manager, Insurance and Claims Advocacy
Sun Life —Baltimore, MD
- $76,200 - $114,300 a year
- Full-time
- Hybrid work
- Microsoft Office
- 3 years
- Bachelor's degree
- AD&D insurance
- Disability insurance
IT Program Manager
US Defense Media Activity —Fort Meade, MD
- $121,785 - $158,322 a year
- Overtime
- Hybrid work
- Background check
- Computer Science
- Bachelor of Science
MRO Customer Program Manager
ST Engineering —Baltimore, MD
- $88,200 - $130,000 a year
- Full-time
- Background check
- Spanish
- Oracle
- Health insurance
- Dental insurance
Program Manager - Pharmacy Supply Chain - (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $106,632 - $211,783 a year
- Full-time
- Remote
- Master's degree
- Analysis skills
- Bachelor's degree
- 401(k)
Quick Apply
Global Casualty Claims Specialist
Under Armour —Baltimore, MD
- $60,000 - $80,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Customer service
- Research
- Store discount
- Health insurance
Manager, Technical Training
Peraton —Windsor Mill, MD
- $104,000 - $166,000 a year
- Master's degree
- Senior level
- Business
- Health savings account
- Paid holidays
Safety and Training Manager
MV Transportation —Baltimore, MD
- $76,000 - $94,000 a year
- Full-time
- Background check
- Classroom
- 5 years
- Health savings account
- AD&D insurance
Director, Medicare Enrollment and Appeals Group
US Centers for Medicare & Medicaid Services —Woodlawn, MD
- $155,661 - $228,000 a year
- Online Application
- Background check
- Pass drug screening
- Office
9d
EEO & Outreach Director (ADMINISTRATOR III)
State of Maryland - Maryland State Retirement and Pension Systems —Baltimore, MD
- $75,475 - $117,737 a year
- Online Application
- Background check
- High school
- Office
- Health insurance
- Dental insurance
6d
Safety Manager
Paniagua's Enterprises Inc —Baltimore, MD
- $75,000 - $100,000 a year
- Weekends as needed
- Microsoft Word
- Spanish
- Clean driving record
- Health savings account
- Health insurance
Quick Apply
13d
Regional Director of Operations - MidAtlantic
Parking Management Company —Baltimore, MD
- Overtime
- Background check
- 3 years
- Analysis skills
- Paid training
- Health insurance
Quick Apply
12d
Captives Underwriter
The Hartford —Hunt Valley, MD
- $124,000 - $199,800 a year
- Full-time
- Hybrid work
- Sales
- Customer service
- Office
Regional Credit Director
Allianz —Baltimore, MD
- $170,000 - $200,000 a year
- Full-time
- Sales
- English
- Business development
- Health insurance
- Tuition reimbursement
Regional Director of Clinical Risk Mgmt- MMCIP
Faculty Physicians Inc. —Baltimore, MD
- $124,400 - $186,600 a year
- Clinic experience
- 3 years
- Master's degree
Quick Apply
11d
Manager of Workplace Safety & Risk Management
Anne Arundel Community College —Arnold, MD
- $76,448 - $95,560 a year
- Full-time
- University
- Bachelor's degree
- US work authorization
Program Lead - CM/CI
RK&K —Baltimore, MD
- Construction site
- 11+ years
- Office
- Paid holidays
- Dental insurance
Quick Apply
Assistant Director of HR- Employee & Labor Relations
Baltimore City Community College —Baltimore, MD
- $90,000 - $105,000 a year
- Full-time
- 5 years
- Writing skills
- Master's degree

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claims program manager jobs near baltimore, md

Pharmacy Program Manager (Hybrid)

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$106,632 - $211,783 a year

Benefits

401(k)

Qualifications

Vendor relationship building
Presentations for conferences or internal meetings
Contracts
Process improvement planning
Research findings presentation

Full Job Description

Resp & Qualifications

PURPOSE:
Manages end-to-end oversight of Pharmacy initiatives. Drives teams and internal projects to maintain and enhance program performance over time. Guides stakeholders through key decisions, communicates and coordinates activities internally and across departments. Facilitates process improvement and identifies and articulates stakeholder needs to drive pharmacy strategies and maximize outcomes related to ROI, customer satisfaction, and organizational metrics and performance.

ESSENTIAL FUNCTIONS:

Manages complex pharmacy program(s) or strategic initiatives that span organizational boundaries and have a significant legal and/or financial impact to CareFirst Business. Identifies process improvement opportunities and takes action to implement enhancements to maximize outcomes and growth.

Coordinates with internal and external stakeholders to launch, maintain, and enhance complex pharmacy program(s). Provides direction and motivation to project teams in a matrixed environment. Drives outcomes by fostering a collaborative culture. Manages relationships with key stakeholders, including management and vendors. Develops and provides formal written and verbal presentations or other communication materials for appropriate management and various committees to support Pharmacy programs and initiatives. Leads innovative solutions to meet pharmacy and corporate goals.

Monitors PBM compliance, financial performance and reconciliations while identifying trends to support strategic decision-making.

Oversees a key initiative focused on the timely and accurate calculation of payments and reconciliations for pharmacy rebates, network discounts and medicate rebates for ASO/CFA accounts.

Measures, evaluates and reports on Pharmacy program(s) performance related to ROI, customer satisfaction, and other organizational metrics. Effectively forecasts and manages people, process and technology related resources to ensure successful achievement of corporate goals.

Guides stakeholders and leadership through key decisions and communicates and coordinates activities internally and across network of partners.

SUPERVISORY RESPONSIBILTY:

Leads a team utilizing a matrix management system.

QUALIFICATIONS:

Education Level: Bachelor's Degree in Business Management or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 8 years project management or program management experience.

Licenses/Certifications:
Certified Project Management Professional (PMP)-PMI Preferred

Preferred Qualifications:

Master's Degree
Project Management Professional Certification (PMP)

Knowledge, Skills and Abilities (KSAs)

Ability to synthesize large complex data and analysis into clear, concise, executive level presentations that allow for rapid grasp of business problem or opportunity and understanding of feasible solutions.
Effective understanding of how functions integrate within the division and the strategic concept behind the corporate goals.
Ability to translate business needs as it relates to technology, systems, and vendor platforms.
Ability to identify and shepherd strategic opportunities that have a significant impact on the organization.
Ability to establish working relationships and influence/persuade across all levels of leadership including C-Suite.
Knowledge and discipline of Process Improvement.
Use of Microsoft Applications.
Strong knowledge of PBM contracting, claims adjudication, pharmacy network management, formulary design, financial processes including rebates and discounts.

Travel Requirements
Estimate Amount: Limited

Salary Range: $106,632 - $211,783

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.

#LI-LJ1

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Refine Your Search

claims program manager jobs in baltimore, md

Pharmacy Program Manager (Hybrid)

Fleet Safety Manager ( Commercial Electrical)

Program Manager/Training Lead

Senior Manager, Insurance and Claims Advocacy

IT Program Manager

MRO Customer Program Manager

Program Manager - Pharmacy Supply Chain - (Remote)

Global Casualty Claims Specialist

Manager, Technical Training

Safety and Training Manager

Director, Medicare Enrollment and Appeals Group

EEO & Outreach Director (ADMINISTRATOR III)

Safety Manager

Regional Director of Operations - MidAtlantic

Captives Underwriter

Regional Credit Director

Regional Director of Clinical Risk Mgmt- MMCIP

Manager of Workplace Safety & Risk Management

Program Lead - CM/CI

Assistant Director of HR- Employee & Labor Relations

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