Remote Jobs at Capital Blue Cross
Find your next remote opportunity · 13 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.
RN Care Manager
Remote RN Care Manager coordinating medical, behavioral, and psychosocial care for Capital Blue Cross members. Managing complex caseloads, referrals, care plans, resources, and health outcomes.
Vendor Alliances Consultant
Vendor alliances consultant managing strategic vendor lifecycles, contracts, negotiations, and performance for Capital Blue Cross. Supporting healthcare business stakeholders with risk, cost, and value optimization.
Customer Service Representative
Customer service representative supporting Capital Blue Cross members, providers, and brokers with health plan inquiries. Researching benefits, claims, billing, enrollment, and customer resolutions remotely.
Health Navigator, LPN
Health Navigator coordinating healthcare services and community resources for members. Collaborating with interdisciplinary teams to improve member health outcomes and experiences.
Manager, Data Engineering
Manager managing a team of 3-4 data engineers at Capital Blue Cross. Overseeing project workflows, quality, and technical guidance for data solutions.
Clinical Support Specialist
Clinical Support Specialist providing administrative support to assigned clinical teams at Capital Blue Cross. Involved in medical management processes and community events coordination.
Network Reimbursement Analyst II
Network Reimbursement Analyst developing and maintaining pricing schedules for healthcare providers at Capital Blue Cross. Collaborating with teams to implement policy changes and improve reimbursement processes.
Provider Audit Specialist
Provider Audit Specialist responsible for auditing hospital charge data and claims. Collaborating with internal teams to ensure billing compliance and recommend improvements.
Senior Business Systems Analyst
Senior Business Systems Analyst providing analytical and technical support for Capital Blue Cross core systems. Collaborating with teams and ensuring innovative solutions for business problems.
Clinical Vendor Consultant
Clinical Vendor Consultant coordinating clinical services and vendor projects for Capital Blue Cross. Collaborating with departments to improve healthcare quality and manage vendor relationships.
HEDIS Performance Analytics Lead
Senior Analyst powering HEDIS improvement initiatives through advanced data analytics and insight generation. Leading development of predictive models and translating findings into actionable recommendations.
Manager, Government Enrollment & Appeals
Manager overseeing enrollment and billing operations across Medicare Advantage and related programs at Capital Blue Cross. Leading compliance efforts and managing appeals and grievances for government programs.
Information Security Specialist
Information Security Specialist at Capital Blue Cross monitoring and responding to cyber threats. Collaborating with IT teams to enhance security posture and compliance with industry standards.
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