Capital Blue Cross

Clinical Development and Education Consultant

Capital Blue Cross · Full Time · an hour ago

Capital Blue Cross

🌎 United States 💵 $63350 - $119K per year ⭐ 5-10 yrs exp 💼 Healthcare

The consultant is responsible for planning, executing, and evaluating educational programs for clinical staff, including onboarding and professional development. They also partner with leadership to manage clinical workflows and ensure compliance with regulatory and accreditation standards.

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Actuarial Analyst

Capital Blue Cross · Full Time · 7 hours ago

Capital Blue Cross

🌎 United States 💵 $63350 - $119K per year ⭐ 0-2 yrs exp 💼 Finance

The Actuarial Analyst assists in determining rates and developing statistical data to support core actuarial functions. Responsibilities include providing support for rate filings, company forecasting, and monthly reserve valuation processes.

forecasting training science

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Manager, Value Delivery

Capital Blue Cross · Full Time · a day ago

Capital Blue Cross

🌎 United States 💵 $98880 - $186K per year ⭐ 10+ yrs exp 💼 Others

The Value Delivery Manager leads Agile product teams to drive business value, optimize delivery performance, and support the transition to a product-centric operating model. They partner with business and technology leaders to manage dependencies, facilitate planning, and coach teams on Agile and Lean practices.

scrum-master agile communication training

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Manager, Risk Adjustment Operations

Capital Blue Cross · Full Time · 5 days ago

Capital Blue Cross

🌎 United States 💵 $83800 - $157K per year ⭐ 5-10 yrs exp 💼 Others

The manager provides end-to-end operational management and support for Medicare Advantage and ACA Risk Adjustment programs. They are responsible for driving execution, managing program performance, and coordinating cross-functional teams to meet strategic initiatives.

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Social Work Care Manager

Capital Blue Cross · Full Time · 15 days ago

Capital Blue Cross

🌎 United States 💵 $28.25 - $53.24 per year ⭐ 2-5 yrs exp 💼 Healthcare

The Social Work Care Manager coordinates services for high-risk members by assessing medical, psychosocial, and behavioral health needs. They develop individualized care plans and collaborate with providers and community agencies to improve member health outcomes.

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Network Reimbursement Analyst II

Capital Blue Cross · Full Time · a month ago

Capital Blue Cross

🌎 United States 💵 $55100 - $103K per year ⭐ 2-5 yrs exp 💼 Others

The analyst develops and administers pricing for healthcare provider contracts and manages the configuration of pricing schedules. They research reimbursement issues and provide analytical support to the Network Provider Contracting and Analytics teams.

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Medical Director - Behavioral Health

Capital Blue Cross · Full Time · a month ago

Capital Blue Cross

🌎 United States 💵 $212K - $344K per year ⭐ 10+ yrs exp 💼 Healthcare

Provide physician leadership and clinical expertise to develop and implement Capital's behavioral health strategy and programs. Collaborate with internal departments and external providers to drive Triple Aim outcomes and improve access to integrated care.

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Enterprise Architect

Capital Blue Cross · Full Time · a month ago

Capital Blue Cross

🌎 United States 💵 $118K - $223K per year ⭐ 5-10 yrs exp 💼 Software Development

Leads architecture for a specific business domain and guides Agile PODs to deliver secure, scalable solutions. Drives application rationalization and adoption of reference patterns in Azure.

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HEDIS Performance Analytics Lead

Capital Blue Cross · Full Time · 3 months ago

Capital Blue Cross

🌎 United States 💵 $83800 - $157K per year ⭐ 10+ yrs exp 💼 Software Development

Lead the development of predictive models and analytical frameworks to identify HEDIS performance gaps and prioritize improvement initiatives. Translate complex data into actionable strategic recommendations for executive stakeholders to improve quality outcomes and ROI.

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