CareFirst Careers

Health Services Advisor

Resp & Qualifications

The position operates as a direct extension of the Vice President providing both strategic and tactical support in the day to day operations of the department. The incumbent performs a combination of tasks and skills including strategic planning, overseeing department priorities, internal and external communications, project management, vendor oversight, reporting and analytics, workforce planning, program implementation and oversight, budget management, cross-company collaborations, and a variety of other activities on behalf of the VP and departmental operations oversight.

Under the general supervision of a Vice President, the incumbent’s accountabilities may include, but are not limited to, the following:

1. Strategic Initiatives and Special Projects

Serves as a resource to departmental leadership for strategic initiatives, special assignments and projects, and preparing related documentation and status updates as required for various levels of leadership.

Manages all aspects of the project/program management of an initiative, which may include: cost benefit analysis, work plans, functional and technical designs, implementation and ongoing monitoring of vendor or customer Service Level Agreements.  Ensures efficient and high-quality installation of new programs and/or services and monitors all aspects of implementing projects. Reviews detailed plans to proactively identifies risks and opportunities and to ensure that the implementation meets defined expectations and are in accordance with overall goals and/or regulatory and compliance requirements.

Researches and conducts necessary analysis in response to requests of the leadership team, and present results as required.  Engages in proactive problem solving including: problem identification, definition, analysis and recommendation as an individual producer and as a catalyst in small group settings.  Deliverables include verbal and/or detailed written reports designed to monitor and ensure delivery against milestones contained in the division’s operational and strategic plan, including monitoring and analysis of key performance indicators.
Leads cross functional groups in support of work deliverables and initiatives.

Provides the analytical and organization support necessary to look at complex business problems, requests or proposals, and distill things down in a way that enables the VP to make critical business decisions and forward progress. Determines the financial and other impacts of making changes to a program or business model and provides recommendations and options that able executive level decision making.

2. Business Alignment and Process Improvement

Partners with VP and departmental senior leaders on business alignment and continuous improvement efforts. Guides the department to understand its current processes end-to-end- both functionally and technically and will drive activities necessary to improve their performance and alignment within the company. Identifies opportunities to streamline workflows and drive efficiencies.  Drives the assessment of barriers and roadblocks, and facilitates cross functional problem solving and solutioning amongst departmental leadership. Provides direction to team on initiatives and deliverables for VP, acting as project manager to synthesize work products and ensure the collective achievement of the deliverable(s).

Prepares and presents materials related to department programs to executive management.  Materials include forecasting of strategic initiatives, status updates on ongoing projects, and areas for improvement within work tracks.  Adjusts future work based on feedback from executive management and supports the realignment of the various key players within the department for repurposed assignment.

3. Department Coordination, Communication, and Education Enablement

Identifies and articulates the metrics to measure success on departmental goals, subgoals and other complex work deliverables. Creates, reviews, refines internal and external communications on behalf of VP including the development and refinement of presentations and summary reports for the department and for multiple levels of audiences both internal and external; policies and procedures for both internal and external usage; coordinating internal reporting requirements for the department and division; or responding or contributing to RFPs or other divisional narratives. Prepares for major meetings by drawing together key documents and oral history; synthesizing and compressing key issues and recommendations; facilitating briefings to clarify views or obtain required additional information in support of the VP and delivery preparation.

Demonstrates ability to provide thorough analysis and recommendations on complex communication issues. Thinks logically and strategically to advance the effectiveness of various communications vehicles in delivering and reinforcing divisional and company messages.

May create content for and/or lead educational sessions within the division and across the company.  Ensures that presentation collateral is created based on audience need (e.g., sales trainings, client facing material, etc.).

4. Relationship Management and Vendor Management:

Builds and maintains a solid professional relationship with members of the department and across CareFirst and is proficient and knowledgeable about the company’s strategy and goals. 
Acts as a liaison across all areas internally including SBUs, Corporate Audit, Finance, Vendor Contracting, Legal, etc. and externally to vendors, consultants, regulatory bodies, etc.

Provides the vendor management of strategic and operational work with a variety of vendors. Conducts weekly meetings to review status of work deliverables related to all vendor functions and collaborates with vendor partners to fulfill management requests on time and accurately. 

5. Budget Management:

Manages and oversees financial/budget related deliverables that span the department including but not limited to: determining staffing ratios; quantifying the cost of care coordination services and other customer related cost analysis; developing methodology and structure of performance guarantees, as well as the monitoring and tracking of performance guarantees on the backend; overseeing the allocation of cost of care and staffing to the appropriate corporate entity; etc.

Coordinates the development and analytical review of the department administrative expense budget, monthly expense analysis including identification/explanation of variances, expense forecasting as well as acquisition (the purchasing and oversight of outside and intra-company services and/or products), and other budget/finance related activities.

Required Education/Experience/Skills/Abilities:

• Bachelor’s degree in Business, HealthCare Management, or a related field. In lieu of Bachelor’s degree, must have 4 years related experience.  

In addition:
• A minimum of 5 years’ experience in healthcare environment, health insurance payor environment, or related industry
• Demonstrated ability to understand business drivers and implement supporting strategies
• Expert ability to synthesize complex data and analysis into clear, concise, executive-level presentations that frame decision options concisely. Experience in executive level reporting on strategic initiatives, developing and delivering effective executive presentations
• Excellent presentation skills. Ability to draft communications specific to the audience, the call to action and or desired business outcome
• Strong teamwork and interpersonal skills, with the ability to influence and persuade customers, employees, and management at all levels and thrive in a cross-functional environment. Ability to negotiate while exercising diplomacy and tact
• Able to lead complex work deliverables across a matrixed environment
• Excellent project management skills, business planning skills and overall organization skills. Proven ability to promote flexibility and teamwork, effectively coordinate resources and manage multiple small to large projects in a cross-functional environment
• Ability to apply critical thinking to short-term, mid-range, and long-term goals
• Proven root cause analysis and problem-solving and solutioning skills
• Must be able to work independently with minimum oversight and demonstrate attention to detail, accuracy and quality awareness
• Strong PC skills (Microsoft Word, Microsoft Outlook, Excel, Power Point)
• Must demonstrate resilience and effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.  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.

• Understanding of managed care concepts and operations
• Health plan experience
• Master’s degree in business administration, information management or public health
• Consulting experience
• Experience monitoring and managing a cost center budget
• Experience with cost/benefit analysis
• Strong knowledge of operational metrics

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.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 8/30/2020

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.


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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