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ACA Risk Adjustment Supervisor at CareFirst BlueCross BlueShield in Owings Mills, MD



$80K — $100K *


Risk & Quantitative Analysis


5 - 7 years

Job Description

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Valid through: 10/23/2020

About CareFirst BlueCross BlueShield

CareFirst BlueCross BlueShield, with dual headquarters in Baltimore, Maryland and Washington, D.C., is a health insurance provider serving 3.3 million individuals and groups in Maryland and the Washington metropolitan area. It is a nonprofit organization and an independent licensee of the Blue Cross Blue Shield Association., The company has a 75% market share in Maryland. It also serves more than 626,000 members in the Federal Employees Health Benefits Program., CareFirst BlueCross BlueShield’s history can be traced back to 1934 when Group Hospitalization, Inc. was formed by a hospital association in Washington, D.C. In 1942, the company was sanctioned to use the Blue Cross service mark and in 1951 became a full participating member of the Blue Cross system., In 1969, Maryland Hospital Service, Inc. and Maryland Medical Service changed their names to Maryland Blue Cross and Maryland Blue Shield., In 1998, the Maryland and District of Columbia companies merged to form CareFirst BlueCross BlueShield., In July 2000, CareFirst announced that it was leaving the Medicare HMO marketplace at the end of the year., In 2001, Wellpoint offered to acquire the company for $1.37 billion, including $119 million in bonuses to Carefirst executives. In 2003, the offer was rejected by the Maryland insurance commissioner., In May 2015, the company announced that a cyber attack in June 2014 compromised the data of 1.1 million current and former members. The breach did not include Social Security numbers, medical claims, employment, credit card or financial information and CareFirst subsequently blocked member access to these accounts and requested members create new user names and passwords., In 2018, Brian D. Pieninck was named CEO. In November, the company announced it may begin offering Medicaid and Medicare Advantage options to consumers as early as 2021., In October 2019, CareFirst partnered with Halcyon, an incubator program, to financially back healthcare startups.
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