Billing Analyst (Remote) Blue Cross and Blue Shield AssociationBilling Analyst (Remote)DCRemote$51,552–$102,388 / yearThis includes establishing and following required technical specifications, managing the accuracy and efficiency of the established process as well as identifying and resolving data and setup issues as it relates to internal billing systems. QUALIFICATIONS: Education Level: Bachelor''s Degree in Accounting, Finance or other math 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.
Actuarial Analyst II - Pharmacy (Remote) Blue Cross and Blue Shield AssociationActuarial Analyst II - Pharmacy (Remote)DCRemote$69,984–$138,996 / yearQUALIFICATIONS: Education Level: Bachelor''s Degree in Mathematics, Finance, Actuarial Science 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. ESSENTIAL FUNCTIONS: Reviews and organizes actuarial and operational data for use in a variety of actuarial analyses that may include rate filings, financial forecasts, IBNR analysis, trend analysis, provider contract analysis, etc.
Senior Data Risk Adjustment Analyst (Remote) Blue Cross and Blue Shield AssociationSenior Data Risk Adjustment Analyst (Remote)DCRemote$87,264–$173,316 / yearKey responsibilities include analyzing program performance, monitoring key performance indicators, supporting risk score forecasting, developing member and provider targeting methodologies, creating and maintaining dashboards and reporting solutions, performing CMS, HHS, and MDH data reconciliations, and conducting ad hoc analyses to identify opportunities for improvement. QUALIFICATIONS: Education Level: Bachelor''s Degree in Data Science, Mathematics, Computer Science, Statistics, Business 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.
Account Consultant III - Mid Market (100-299) - (Remote) Blue Cross and Blue Shield AssociationAccount Consultant III - Mid Market (100-299) - (Remote)DCRemote$89,600–$145,600 / yearQUALIFICATIONS: Education Level: Bachelor''s Degree in Business, Finance 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. PURPOSE: This position is responsible for renewing/growing a book business which includes more complex accounts with indemnity and managed care medical products, ancillary/specialty products, and life products.
Payment and Medical Policy Coordinator (Remote) Blue Cross and Blue Shield AssociationPayment and Medical Policy Coordinator (Remote)DCRemote$51,264–$101,816 / yearThis role ensures business readiness across impacted functions, including claims, configuration, provider communications and operations, and provides support during testing, implementation, and post-implementation validation. QUALIFICATIONS: Education Level: Bachelor''s Degree in Health Administration, Business, Finance or related discipline 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.
Functional Analyst II - Pharmacy (Remote) Blue Cross and Blue Shield AssociationFunctional Analyst II - Pharmacy (Remote)DCRemote$55,296–$109,824 / yearThe analyst partners with Finance, Account Management, analytics teams and other key stakeholders to deliver accurate reporting, resolve issues and identify insights that improve pharmacy financial performance. QUALIFICATIONS: Education Level: Bachelor''s Degree in Business Administration 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.
Data Engineering Manager (Remote) Blue Cross and Blue Shield AssociationData Engineering Manager (Remote)DCRemote$136,720–$253,787 / yearIn addition to people leadership responsibilities, the Manager, Data Engineering will provide technical leadership for the design, development, and operation of modern data engineering solutions, including data pipelines, integrations, cloud-based platforms, data transformation processes, and enterprise data products. This role will be responsible for ensuring the reliability, scalability, security, and performance of critical healthcare data assets while driving modernization efforts, engineering best practices, platform stability, automation, and operational excellence across a complex data ecosystem.
Account Consultant III - CFA (Remote) Blue Cross and Blue Shield AssociationAccount Consultant III - CFA (Remote)DCRemote$89,600–$145,600 / yearQUALIFICATIONS: Education Level: Bachelor''s Degree in Business, Finance 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. PURPOSE: This position is responsible for renewing/growing a book business which includes more complex accounts with indemnity and managed care medical products, ancillary/specialty products, and life products.
Risk Adjustment Coding Specialist (Remote) Blue Cross and Blue Shield AssociationRisk Adjustment Coding Specialist (Remote)DCRemote$51,984–$95,304 / yearPURPOSE: The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, HHS-Risk Adjustment Data Validation (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines. QUALIFICATIONS: Education Level: Associate''s Degree in Health Information Technology, Business or related field OR in lieu of a Associate degree, an additional 2 years of relevant work experience is required in addition to the required work experience.
Clinical Appeals Nurse (Remote) Blue Cross and Blue Shield AssociationClinical Appeals Nurse (Remote)DCRemote$67,320–$133,705 / yearESSENTIAL 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 initiators. Investigates, interprets, analyzes and prioritizes appeal requests using nursing expert knowledge and all available clinical information for both medical and behavioral health conditions, as well as medical policies, to determine if the adverse coverage and adverse decisions are appropriate.
Senior Procurement Integration Engineer (Remote) Blue Cross and Blue Shield AssociationSenior Procurement Integration Engineer (Remote)DCRemote$98,784–$196,196 / yearArchitect and support integrations between: Workday Procurement Finance (AP/GL), Workday external supplier systems, punchout catalogs, and marketplaces, Legacy systems including SAP Ariba and Oracle Financials. This role will lead the design, development, and support of end-to-end procurement technology solutions, including requisition-to-pay workflows, supplier integrations, catalog enablement, and downstream financial integrations.
Senior Medical Coding Specialist (Remote) Blue Cross and Blue Shield AssociationSenior Medical Coding Specialist (Remote)DCRemote$67,464–$133,991 / yearThis role utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. Consults with various teams, including the Practice Transformation Consultants, Medical Policy Analysts and Provider Networks colleagues to interpret coding and documentation language and respond to inquiries from providers.
REMOTE Procurement Indirect Category Manager Metasys TechnologiesREMOTE Procurement Indirect Category ManagerMcLean, VARemote$40–$80 / yearThe Procurement Indirect Category Manager will develop and maintain an effective view of our indirect categories, including Marketing & Sales, Legal, Facilities, Station Operations, Corporate, as well as Telecom, Broadcast Technology, and Information Technology spend. • More than 6 years of category management experience in indirect categories (including Marketing & Sales, Legal, Facilities, Corporate, and other assigned categories) within a procurement or strategic sourcing function.
Remote Principal Full Stack Software Engineer Butterfly Network IncRemote Principal Full Stack Software EngineerMDRemoteIn addition to its medical imaging products, Butterfly Embedded is the Company's Ultrasound-on-Chip licensing and co-development program designed to enable a new wave of ultrasound-enabled technologies across non-competitive healthcare markets and beyond. In doing so, we manage and maintain our customers' administration of users and organizations, ensuring feature and entitlement management, as well as building scalable, platform-level enterprise features such as global search and audit logging.
Application Security Engineer - Mid-Atlantic region Remote in VA, MD, PA, NC, DE, NJ, or DC Guidepoint Security LLCApplication Security Engineer - Mid-Atlantic region Remote in VA, MD, PA, NC, DE, NJ, or DCWashington, DCRemoteBy taking a three-tiered, holistic approach for evaluating security posture and ecosystems, GuidePoint enables some of the nation's top organizations, such as Fortune 500 companies and U.S. government agencies, to identify threats, optimize resources and integrate best-fit solutions that mitigate risk. Group Medical Insurance options: Zero Deductible PPO Plan (GuidePoint pays 90% of the premium for employees and 70% for family plans (spouse/children/family) or High Deductible Health Plan with HSA (GuidePoint pays 100% of the employees premiums and 75% for family plans (spouse/children/family).
Landscaping Sales Specialist at Frederick Landscaping (Remote) People Solutions CenterLandscaping Sales Specialist at Frederick Landscaping (Remote)New Windsor, MDRemoteThis role has the flexibility to start and end the workday from a home office and will primarily involve fieldwork, with weekly meetings held in the office making this role an easy commute from Frederick, Westminster, Libertytown, and other surrounding areas. Requirements for the Landscape Maintenance Sales Representative at Frederick Landscaping: Minimum of 3 years of experience in a sales position within a landscaping company, nursery, or similar green industry organization.
Senior Remote Tower Systems Engineer Chickasaw Nation Industries, Inc.Senior Remote Tower Systems EngineerWashington, DCRemote$131,600–$150,000 / yearThe Senior Remote Tower Systems Engineer position will work as part of a team supporting research and development, safety studies, technical reviews and data collection and analysis in support of Federal Aviation Administration (FAA) Remote Tower program. Chickasaw Nation Industries, Inc. serves as a holding company with multiple subsidiaries engaged in several lines of business (Business Services, Health, Infrastructure and Engineering, Mission Optimization, Technology and Transportation) for the federal government and commercial enterprises.
Engineering Manager - Core Infrastructure (Remote) CrowdStrike IncEngineering Manager - Core Infrastructure (Remote)Washington, DCRemote$150,000–$200,000 / yearWe focus on creating self-service infrastructure-as-a-code primitives, ensuring high availability, and optimizing our cloud footprint to empower our engineering teams to move faster with confidence. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
Engineer III - CICD Code Signing Automation (Remote) CrowdStrike IncEngineer III - CICD Code Signing Automation (Remote)MDRemote$120,000–$180,000 / yearAbout the Role: On the Engineering Systems team at CrowdStrike, we operate and maintain many of the systems and services that support the build, test, signing, and deployment of our software to the cloud and to our customers, as well as providing consultation, troubleshooting, and engineering support for the creation and maintenance of the pipelines that provide those functions. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
Remote Sprinkler Designer Actalent IncRemote Sprinkler DesignerHanover, MDRemote$43.27–$52.88 / hourWe are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.