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Regence Blue Shield Remote Jobs (NOW HIRING)

Bcbsa

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

Bcbsa

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

Bcbsa

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

Bcbsa

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

Bcbsa

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

Bcbsa

Product Manager Value Based Contracting Operations

OR · Remote

$131K - $189K/yr

... within the Blue Cross Blue Shield system Knowledge Skills and Abilities * Possesses strong ... Remote $131,908.00 - $189,738.00 This is the lowest to highest salary we, in good faith, believe we ...

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All JobsRegence Blue Shield JobsRegence Blue Shield Remote Jobs

Regence Blue Shield Remote information

See salary details

$28K

$71.3K

$141K

How much do regence blue shield remote jobs pay per year?

As of Jun 14, 2026, the average yearly pay for regence blue shield remote in the United States is $71,292.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,500.00 and $97,500.00 per year, depending on experience, location, and employer.

What is the difference between Regence Blue Shield Remote vs Customer Service Representative?

AspectRegence Blue Shield RemoteCustomer Service Representative
CredentialsHealth insurance knowledge, customer service skillsHigh school diploma or equivalent, customer service skills
Work EnvironmentRemote, home-basedRemote or office-based, depending on employer
Industry UsageHealth insurance companies, healthcare industryVarious industries, including healthcare, retail, finance
Common Search IntentRemote health insurance support jobsCustomer support roles in various sectors

Regence Blue Shield Remote positions typically require health insurance knowledge and customer service skills, often offered as remote roles within the healthcare industry. Customer Service Representatives also provide support but may work in multiple industries and may not always require specialized insurance knowledge. The main difference lies in industry focus and specific credentials, with Regence Blue Shield Remote roles being specialized in health insurance support.

What jobs pay $10,000 a month without a degree?

High-paying remote jobs that can reach $10,000 a month without a degree include roles like sales representatives, real estate brokers, and certain freelance or consulting positions such as digital marketing or software development. Success in these roles often depends on skills, experience, and performance rather than formal education, and they may require certifications or strong portfolios.

What is a Regence Blue Shield remote job?

A Regence Blue Shield remote job refers to a position with Regence Blue Shield—a health insurance provider—where employees work from a location outside of the company’s physical offices, typically from home. These roles span various departments such as customer service, claims processing, IT, and healthcare management. Remote employees use digital tools to collaborate, process information, and meet job responsibilities. Working remotely with Regence Blue Shield offers flexibility and the opportunity to balance professional and personal commitments. The company provides support and resources to ensure remote workers are productive and connected.

What is the best insurance company to work for remotely?

Regence Blue Shield offers remote positions in the insurance industry, providing opportunities for roles such as customer service, claims processing, and administrative support. The company is known for flexible work arrangements and a focus on employee benefits, making it a competitive option for remote insurance jobs.

How much does Blue Cross Blue Shield pay work from home?

Regence Blue Shield remote positions typically offer pay rates that align with industry standards for health insurance roles, often ranging from $15 to $25 per hour depending on experience and specific job responsibilities. Compensation may also include benefits such as health insurance, flexible schedules, and remote work tools. Exact pay varies by role, location, and experience level.

How can I make 2000 a week working from home?

To earn $2000 weekly working remotely, roles such as customer service representative, insurance claims adjuster, or remote healthcare professional often pay in that range with full-time hours. Developing relevant skills, certifications, and experience in high-demand remote jobs can help achieve this income level, typically requiring consistent work and sometimes specialized training.

What are some common challenges faced by employees working remotely for Regence Blue Shield, and how can they be addressed?

Remote employees at Regence Blue Shield may encounter challenges such as maintaining effective communication with team members, staying engaged with company culture, and managing work-life balance. To address these, the company provides collaboration tools, regular virtual meetings, and access to internal resources for professional development and wellness. Proactively reaching out to colleagues, setting clear boundaries for work hours, and participating in virtual team activities can also enhance the remote work experience and foster a sense of connection.

What are the key skills and qualifications needed to thrive as a Regence Blue Shield Remote employee, and why are they important?

To thrive in a remote position at Regence Blue Shield, you generally need a background in healthcare administration, insurance, or customer service, often with a relevant degree or certifications. Familiarity with health insurance platforms, claims processing systems, and secure communication tools is typically required. Strong organizational skills, self-motivation, and effective virtual communication help individuals excel in a remote environment. These skills are crucial for ensuring efficient service delivery, accurate processing, and seamless collaboration while working remotely.
What cities are hiring for Regence Blue Shield Remote jobs? Cities with the most Regence Blue Shield Remote job openings:
What are the most commonly searched types of Regence Blue Shield jobs? The most popular types of Regence Blue Shield jobs are:
What states have the most Regence Blue Shield Remote jobs? States with the most job openings for Regence Blue Shield Remote jobs include:
What job categories do people searching Regence Blue Shield Remote jobs look for? The top searched job categories for Regence Blue Shield Remote jobs are:
Regence Blue Shield Remote jobs near you
Infographic showing various Regence Blue Shield Remote job openings in the United States as of June 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% Remote job distribution, with an average salary of $71,292 per year, or $34.3 per hour.

Sr Medical Director

Blue Cross and Blue Shield of Nebraska

Omaha, NE • On-site, Remote

Full-time

Posted 11 days ago

Blue Cross & Blue Shield Of Nebraska rating

7.7

Company rating: 7.7 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

177th of 261 rated insurance

Job description

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you'll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.
The Senior Medical Director, Utilization Management is the physician leader accountable for strategic and operational leadership of utilization management (UM) programs across commercial, ACA, and/or Medicare Advantage lines of business. This role provides enterprise-level clinical leadership to ensure UM programs improve quality, appropriateness of care, provider collaboration, and total cost of care, while meeting regulatory, accreditation, and compliance standards.
This position serves as the senior clinical authority for UM policy, decision-making, and performance, and leads other Medical Directors and clinical staff engaged in utilization review, prior authorization, and medical necessity determinations.
Candidates applying to this position may be hybrid or remote and can live in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas. The candidate selected for this role will be required to visit the Omaha based job site for occasional strategic meetings throughout the year.
Key Responsibilities
Strategic & Clinical Leadership
  • Provide clinical leadership for utilization management programs, including prior authorization, concurrent review, retrospective review, and appeals.
  • Set UM strategy aligned with organizational goals for affordability, quality, member experience, and regulatory compliance.
  • Serve as senior clinical advisor to executive leadership on utilization trends, risk areas, and intervention opportunities.
  • Oversee the medical policy team, development and refinement of utilization management policies, protocols, and criteria based on nationally recognized standards (e.g., MCG, InterQual)
  • Lead the Medical Policy and Utilization Management Governance Committees

Medical Decision-Making & Oversight
  • Oversee complex and high-risk utilization review cases, including medical necessity determinations and claim reviews.
  • Conduct clinical reviews and/or oversee peer-to-peer reviews with ordering and attending providers.
  • Ensure consistent, evidence-based application of clinical guidelines and medical policy across all UM functions.
  • Provide clinical expertise to teams conducting coding, payment integrity, and reimbursement activities.
  • Contribute medical expertise to case management and care coordination processes, ensuring members transition to the appropriate level of care.

Provider & Stakeholder Engagement
  • Act as senior clinical UM liaison to network providers, facilities, and delegated UM partners.
  • Build and maintain strong physician relationships to support appropriate utilization, practice transformation, and quality improvement.
  • Represent Medical Management in cross-functional leadership forums (Quality, Network, Pharmacy, Population Health).

Program Performance & Improvement
  • Lead development and implementation of UM interventions that reduce unnecessary utilization while maintaining or improving quality outcomes, including strategies for integration of AI technologies to improve efficiency, accuracy of reviews, and user experience.
  • Review utilization data, denial patterns, appeals outcomes, and inter-rater reliability results to identify improvement opportunities and develop solutions for implementation and continuous quality improvement
  • Oversee performance and outcomes generated by contracted UM vendors
  • Ensure UM programs meet CMS, URAC, and state regulatory requirements.
  • Support workforce development, consistency of decision-making, and clinical calibration across UM teams.
  • Conduct and support training of medical directors and UM staff

Required Qualifications
  • Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO).
  • Board Certified by an American Board of Medical Specialties (ABMS) board.
  • Preferred current, unrestricted medical license in Nebraska. If not currently actively licensed in Nebraska, verification of attainment within 6 months of start.
  • 10+ years of combined clinical practice and health care industry experience.
  • Demonstrated experience in utilization management, medical necessity review, and physician peer review
  • Demonstrated effective communication skills, a commitment to continuous improvement in healthcare delivery, and the ability to adapt to a dynamic and rapidly evolving healthcare environment

Preferred Qualifications
  • Prior experience in a senior or enterprise-level UM leadership role.
  • Three + years Managed care experience across Commercial and/or Medicare Advantage populations.
  • Experience leading or overseeing other Medical Directors.
  • Strong background in quality improvement, population health, and cost containment initiatives.

To be considered for this position, you must have:
  • Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO).
  • Board Certified by an American Board of Medical Specialties (ABMS) board.
  • Active, current, and unrestricted Nebraska clinical license within 6 months of start date that would allow the incumbent to apply their clinical judgement in consideration of an individual member's clinical needs to render a utilization review determination.
  • 10+ years of combined clinical practice and health care industry experience.
  • Demonstrated experience in utilization management, medical necessity review, and physician peer review.
  • Demonstrated effective communication skills, a commitment to continuous improvement in healthcare delivery, and the ability to adapt to a dynamic and rapidly evolving healthcare environment.

An equivalent combination of education and experience may be substituted for this requirement.
The ability to meet or exceed the attendance and timeliness requirements of their departments.
The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.
The strongest candidates for this position will also possess:
  • Prior experience in a senior or enterprise-level UM leadership role.
  • Three + years Managed care experience across Commercial and/or Medicare Advantage populations.
  • Experience leading or overseeing other Medical Directors.
  • Strong background in quality improvement, population health, and cost containment initiatives.

Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.
We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

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