- Conduct coverage reviews based on member plan benefits and policies.
- Document clinical review findings, actions, and outcomes.
- Communicate and collaborate with providers for benefit determinations.
Capital Blue Cross
2 open remote positions
Capital Blue Cross promises to go the extra mile for their team and community. They foster a flexible environment where health and wellbeing are prioritized and employees consistently vote it as one of the "Best Places to Work in PA."
Salary Distribution 2 of 2 jobs
$150
Min
$34,435
25th
$68,720
Median
$103,005
75th
$137,290
Max
Benefits Overview 1 of 2 jobs
Dental
(1)
Holidays
(1)
Medical
(1)
Paid Time Off
(1)
Retirement Plan
(1)
Tuition Reimbursement
(1)
Vision
(1)
Open Positions
$72,870–$137,290/yr
- Oversees daily operations of the Care Management unit and ensures process implementation.
- Facilitates staff development, provides regular performance feedback, and identifies areas of improvement.
- Evaluates performance metrics, supports staff in care planning, and promotes interdisciplinary collaboration.