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Remote Highmark Blue Shield Jobs (NOW HIRING)

Ria Health

Alcohol and Drug Abuse Counselor- Remote

$24 - $26/hr

... Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health. Ria Health will enable patients to achieve long term success in reducing or eliminating their ...

Ria Health

Alcohol and Drug Abuse Counselor- Remote

$20.75 - $28/hr

... Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health. Ria Health will enable patients to achieve long term success in reducing or eliminating their ...

Ria Health

Alcohol and Drug Abuse Counselor- Remote

$24 - $26/hr

... Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health. Ria Health will enable patients to achieve long term success in reducing or eliminating their ...

Ria Health

Alcohol and Drug Abuse Counselor- Remote

$24 - $26/hr

... Blue Shield, UnitedHealth Group Optum, Beacon Health Options, Highmark Health, and Magellan Health. Ria Health will enable patients to achieve long term success in reducing or eliminating their ...

County of Nevada, CA

Senior Management Technician

$68K - $84K/yr

... Type: Full Time Remote Employment: Flexible/Hybrid Job Number: 2026-0113 Department: Human ... Blue Shield CalPERS Access+ HMO * Blue Shield Trio HMO * Kaiser HMO * PERS Gold PPO (County ...

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Remote Highmark Blue Shield information

What does a remote Highmark Blue Shield employee do?

A Remote Highmark Blue Shield employee typically works from a location outside of the company’s physical offices, providing services such as customer support, claims processing, case management, or administrative duties for Highmark Blue Shield, a major health insurance provider. These roles are focused on supporting members, resolving inquiries, processing insurance claims, and ensuring quality care management. Remote employees use digital tools and secure platforms to communicate, manage data, and collaborate with their teams while maintaining confidentiality and compliance with healthcare regulations.

What are the key skills and qualifications needed to thrive as a remote Highmark Blue Shield customer service representative?

To thrive as a Remote Highmark Blue Shield Customer Service Representative, you need strong communication skills, knowledge of health insurance products, and at least a high school diploma or equivalent. Familiarity with customer relationship management (CRM) systems, call center software, and basic computer applications is typically required. Excellent problem-solving abilities, patience, and professionalism help you excel in assisting members and resolving their concerns. These skills ensure efficient service delivery, accurate information, and positive customer experiences while working remotely.

How does working remotely for Highmark Blue Shield impact day-to-day collaboration with colleagues and supervisors?

Working remotely at Highmark Blue Shield often involves using digital communication tools such as Microsoft Teams, Zoom, and email to stay connected with your team and supervisors. You will likely participate in virtual meetings, regular check-ins, and collaborative projects, ensuring alignment with company goals and team objectives. While remote work offers flexibility, it also requires proactive communication and strong time-management skills to stay productive and engaged. Many remote employees find that they can effectively collaborate and build relationships through these virtual channels, though it may take some adjustment compared to in-person interactions.
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Infographic showing various Remote Highmark Blue Shield job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Actuarial Svcs Trend & Network Mgr

Blue Cross and Blue Shield of Nebraska

Omaha, NE • On-site, Remote

Full-time

Posted 15 days ago

Blue Cross & Blue Shield Of Nebraska rating

7.7

Company rating: 7.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

204th of 308 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.

This role leads the development and oversight of key actuarial functions that support the organization's financial performance and strategic decision-making. This position is responsible for guiding actuarial analyses related to pricing trends, network and area factors, provider performance, Medicare Advantage, forecasting and other healthcare actuarial initiatives.

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.

What you'll do:

  • Manipulate and analyze data using SQL, Databrick and Excel.

  • Maintain and improve the Pricing Trend methodology, process, and documentation.

  • Maintain and improve the Network/Area factors methodology, and Provider entity performance analysis and documentation.

  • Oversee the monthly Medicare Advantage IBNR, Quarterly & Annual Statement, Risk Adjustment analysis and other related projects. Support the Bid process.

  • Support the corporate reinsurance program, such as renewal, monthly reporting, and filing for reimbursement.

  • Provide VBC Trend and support other VBC activities.

  • Manage the Actuarial Services department workflows.

  • Prepare and present reports to internal management.

  • Accountable to coach, motivate and provide leadership to direct reports.

  • Serve on cross functional teams to represent actuarial point of view.

To be considered for this position, you must have:

  • Bachelor's degree in actuarial science, Mathematics, Statistics, or related field.

  • Five years of experience in an actuarial role and three years of experience in the health care industry.

  • ASA Licensure/Certification.

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:

  • Three (3) years of leadership experience.

  • Experience leading healthcare actuarial analyses and developing actuarial methodologies.

  • Strong communication and presentation skills, including the ability to explain complex findings to business and executive leadership.

  • Experience improving actuarial processes through automation, artificial intelligence, or advanced analytics.

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.

What Blue Cross & Blue Shield Of Nebraska employees say

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