Job Description
**Resp & Qualifications**
**PURPOSE:**
The Payment Policy Manager will ensure that CareFirst maintains accurate, compliant, and financially sound payment policies to support consistent claims adjudication and a value-based health care system. This role is responsible for the research, development, maintenance, and implementation of corporate payment and reimbursement policies aligned with regulatory requirements, provider contracts, and corporate payment strategy. We are looking for an experienced people leader in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.
**ESSENTIAL FUNCTIONS:**
+ Manages the research, development, maintenance, and implementation of corporate payment and claims adjudication policies. Collab...
**PURPOSE:**
The Payment Policy Manager will ensure that CareFirst maintains accurate, compliant, and financially sound payment policies to support consistent claims adjudication and a value-based health care system. This role is responsible for the research, development, maintenance, and implementation of corporate payment and reimbursement policies aligned with regulatory requirements, provider contracts, and corporate payment strategy. We are looking for an experienced people leader in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.
**ESSENTIAL FUNCTIONS:**
+ Manages the research, development, maintenance, and implementation of corporate payment and claims adjudication policies. Collab...