Remote Jobs at Capital Blue Cross
Find your next remote opportunity · 18 Open Positions
At Capital Blue Cross, we promise to go the extra mile for our team and our community.
This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and well-being are prioritized.
At Capital you will work alongside a diverse and caring team of supportive colleagues and be encouraged to volunteer in your community.
We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.
And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.
To increase employee engagement and provide opportunities for networking, learning, career development, and community outreach, Capital also has several Employee Resource Groups.
Our goal is to involve all employees in helping us to create a culture of acceptance, understanding, and growth.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley.
Provider Audit Specialist
Capital Blue Cross
Provider Audit Specialist conducting audits of hospital charge data and claims. Collaborating with internal teams to recommend improvements and ensure adherence to standards.
Government Programs Risk Adjustment Coder
Capital Blue Cross
Government Programs Risk Adjustment Coder ensuring accurate diagnosis coding for Medicare Advantage and ACA lines. Collaborating with teams to improve clinical documentation and maintain compliance.
File Transfer Administrator
Capital Blue Cross
MOVEit Administrator managing secure, automated file transfers across enterprise systems. Administering MOVEit platforms and optimizing workflows for data exchanges with business partners.
Senior Reimbursement Policy Consultant – CPC
Capital Blue Cross
Senior Policy and Reimbursement Consultant guiding provider reimbursement policies and methodologies at Capital Blue Cross. Ensuring proper coding and compliance with industry standards and regulations in healthcare reimbursement.
Senior Reimbursement Policy Consultant
Capital Blue Cross
Senior Policy and Reimbursement Consultant at Capital Blue Cross integrating coding and reimbursement policies. Analyzing, developing, and supporting correct coding while serving as a subject matter expert.
Operations Business Analyst
Capital Blue Cross
Analytical role providing technical and problem resolution support to Health Plan Operations at Capital Blue Cross. Responsibilities include analysis, reporting, and collaboration with team members and customers.
Medicare Risk Adjustment Program Support Specialist
Capital Blue Cross
Provides administrative support for Risk Adjustment programs at Capital Blue Cross. Engages in coordinating medical records and facilitating department compliance tasks.
Risk Adjustment Program Support Specialist
Capital Blue Cross
Administrative support specialist handling Risk Adjustment tasks at Capital Blue Cross. Coordinating medical records and documentation while ensuring compliance and performance.
Customer Service Representative
Capital Blue Cross
Customer Service Representative providing efficient, courteous service to members and providers via various channels. Researching inquiries, ensuring customer satisfaction, and assisting Marketing personnel.
Data Scientist III
Capital Blue Cross
Senior Data Scientist leading complex analytics initiatives and shaping strategic direction at Capital Blue Cross. Driving hands-on modeling and mentoring team members across the organization.
Medicare Risk Adjustment Program Analyst
Capital Blue Cross
Medicare Risk Adjustment Program Analyst providing analytical support and ensuring compliance with government regulations. Collaborating on initiatives related to clinical, claims, and enrollment data.
Principal Voice Engineer
Capital Blue Cross
Principal Voice Engineer handling voice and contact center platforms at Capital Blue Cross. Leading projects and providing technical expertise, ensuring alignment with enterprise strategy.
Group Implementation Manager
Capital Blue Cross
Group Implementation Manager at Capital Blue Cross overseeing onboarding of new group customers and renewals of existing groups. Collaborating with various operational areas to create innovative solutions for business issues.
Manager – Government Programs Performance Analytics
Capital Blue Cross
High-impact analytical role supporting financial performance and strategic insights for Medicare Advantage and ACA portfolios. Acting as financial advisor and connecting data to enterprise-level strategy.
RN Care Manager
Capital Blue Cross
Care Manager coordinating healthcare services for members to promote quality care and outcomes. Engaging in assessments, care plans, and member relationships for optimal health support.
Part Time Medical Director – Behavioral Health, Psychiatrist
Capital Blue Cross
Behavioral Health Medical Director providing clinical leadership at Capital Blue Cross. Overseeing medical necessity reviews and collaborating to improve member outcomes in behavioral health.
Performance Analyst
Capital Blue Cross
Performance Analyst role handling audits related to Membership, Claims, and Customer Service functions at Capital Blue Cross. Providing analysis, reports, and feedback on Performance Guarantee Accounts.
RN Care Manager – Transplant
Capital Blue Cross
Care Manager coordinating services for health plan members to promote quality care and effective outcomes. Collaborating with community agencies and resources to achieve optimal health.
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