CareFirst Careers

Program Manager, Business Process Improvement

Resp & Qualifications

PURPOSE:  Manages a complex, program of strategic/regulatory projects that span organizational boundaries, manages multiple high-risk projects, including projects involving external vendors and multiple business areas that have a significant regulatory compliance, legal and/or financial impact to CareFirst Business.  This role will help build a center of excellence within the organization to drive efficiency and effectiveness of business and IT processes, execute problem solving,  conduct issue and gap identifications and develop performance improvement measures to drive business results.  The incumbent will be play an integral role in the identification of process improvement strategies and execution of projects to improve operational effectiveness;  In addition, this role will oversee multiple workstreams and must collaborate with multiple functions to identify opportunities, conduct analysis, and develop executive-level presentations to share key findings and key recommendations. Utilizes a comprehensive understanding of corporate initiatives to ensure compliance with organization goals and timelines.  Manages the assignment, development and performance of Project Managers under the program.  Responsible for execution/delivery of each project within a program(s) within a domain and/or corporate initiative.  Manages and is responsible for all aspects of the program to include process improvement, and technology applications/development and for enabling the business to strategic goals and objectives prioritized by Senior Management. Communication skills are required to persuade, gain cooperation, provide formal presentations to various sized groups and to reach consensus and resolve conflict.  Excellent written skills are required to prepare reports/documents for internal presentations as well as presentation to various Senior Leadership committees.  Advanced planning, organization, analytics and business acumen are required to understand and present the implications of various decisions.  Manages the delivery efforts of Managers and Directors of other Departments and will provide leadership and influence for VP levels and above.

ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited to, the following:

Duties and Responsibilities
Program Management: Improve existing processes through the identification, support, and execution of projects. This position will support Six Sigma, Lean or other types of business process improvement efforts focused on improving operational effectiveness.

  • Manage and facilitate cross-functional teams to identify business process improvement opportunities
  • Engage in continuous problem solving, cost-benefit analysis, solution development, and implementation oversight
  • Drive performance improvement through improved end-to-end process design and management.
  • Create standardized methods and approaches for business process management
  • Liaise with key stakeholders to enhance operational efficiencies and process effectiveness
  • Develop quality solutions ensuring compliance and adherence to internal audits and regulation standards
  • Advise executive teams on business value of process changes and progress using clear reporting methods
  • Quantify information and prioritizing project tasks – overseeing project management
  • Identification and measurement of performance targets
  • Data analysis of existing processes and information flows
  • Analyze business and IT processes and information to construct clear findings resulting in improvement recommendations, such as designing changes to a functional unit’s workflow and influencing others to buy in on those changes.
  • Use project management, internal audit, Six Sigma, Lean or other business process improvement methodologies to deliver operational improvements in specific time frames.
  • Analyze processes, audit results and data trends, recommend action and assist with implementation of strategies that drive continual improvement. 
  • Identify critical technical/process issues and data driven opportunities to develop and implement corrective actions, as necessary. 
  • Assist with the research of internal and external best practices and remain current in new quality tools, techniques and practices.
  • Coordinate, facilitate, document, and report all aspects of assigned project(s) utilizing project plans and work plans for tracking assigned workload.

Project Management:

  • Manages and directs multiple medium to large-scale projects. 
  • Works on complex problems where analysis of situation or data requires an in-depth evaluation of various factors to achieve best results.
  • Evaluates complex situations accurately and identifies viable solutions that create successful outcomes for the customer.
  • Works with the Business areas in the Operational Readiness activities to provide support and coordination to ensure adoption of new systems and business processes in the CareFirst environment.  
  • Utilize operations, , claims and other reportable data to assess business processes, controls, and the service provided by our plan. Measurements may be used to support regulatory goals, associate performance, provider profiles, business initiatives, incentive programs, etc.
  • Facilitate and support in the design, collection and analysis of clinical, operations and member/provider satisfaction studies to monitor or improve performance.
  • Identify key indicators to support strategic objectives
  • Monitor and evaluate the quality, accuracy, efficiency and effectiveness of programs, and initiatives
  • Support the design and evaluation of system upgrades and enhancements

Reporting and Information Governance: These may include, but is not limited to, the following:

  • Create cost-benefit analyses and business cases for business process improvement efforts.
  • Generate and compile reports based on findings, including recommended improvements to or new requirements for business processes and operational procedures.
  • Update and maintain several departmental reports for internal use and for distribution to senior management.

Bachelors degree in Computer Science, Business, or equivalent work experience required.  8+ years of IT and business experience in strategic planning, development and implementation, preferably in health insurance or other regulated compliance environment.  Previous technical project management experience in a dynamic high-technology environment and an understanding of the regulatory environment affecting health insurance business is a key to success in this position.

Out of the 8 years required, at least 5 years in a combination of the following:
•   Progressive broad-based information systems Project Management experience (which could include consulting) with state-of-the-art hardware and software systems is desirable; knowledge and implementation experience in new computing architectures and networked computing structures. 
•   Experience in Program Management and execution of multiple related development projects simultaneously, particularly as Project Manager on systems development, with working knowledge of  Systems Development Lifecycle and the Project Management Lifecycle

Master’s degree in Business, Health Care, Public Policy or Technology related field.  Prior Health insurance industry exposure; specific experience with successful large-scale Program Management within a cross functional environment.   Project Management certificate (PMP) from the Project Management Institute (PMI)


  • Masters degree in business, IT or health related field is preferred
  • Certification in QI (CPHQ), TQM, six-sigma, internal auditing (CIA), etc.
  • Experience with accreditation survey process
  • Experience in health plans
  • Business process or IT/IS analysis

•   Ability to lead dynamic, energized, and highly creative multidiscipline high-performance work teams in learning and applying new skills/techniques to respond to business needs.
•   Ability to effectively adapt to rapidly changing regulatory environment and apply it to business and technical needs.
•   Considerable experience managing and delivering Business and IT centric projects using (where appropriate) leading-edge technology, and older legacy systems. 
•   Thorough knowledge and understanding of the company’s business practices and direction, business principles, and business processes, plus familiarity with the company’s products           and resources.
•   Considerable experience and effectiveness in matrix management. 
•   Solid teamwork and interpersonal skills, with the ability to communicate and persuade customers, employees, and management at all levels and thrive in a cross-functional environment. 
•   Excellent oral and written communications; an ability to present and discuss regulatory and technical information in a way that establishes rapport, persuades others, and gains               understanding.
•   Strong management, business planning, and development skills.
•   Exceptional program management skills and project management skills, effectively arranging resources and managing multiple small to large projects in a cross-functional environment.
•   Ability to analyze project needs and determine resources needed to meet objectives.
•   Ability to create original concepts and take heuristic approaches to testing/refining existing theories and to develop new system approaches to solve problems and seize opportunities to sustain business success. 
•   Strong analytical, problem-solving, and conceptual skills.
•   Willingness to travel to multiple locations within greater Baltimore/Washington area for meetings and time limited project work.
•   Willingness to work occasional night and weekends related to project releases and key deliverables
•   Competent in the Microsoft Suite of tools such as Project, PowerPoint , Excel, Word, etc.

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: 3.12.21

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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