Mass General Brigham Health Plan
Six major aims for care
Mass General Brigham Health Plan believes that quality care should be:
- Safe: Care that is intended to help patients should not injure them.
- Effective: Services should be based on scientific knowledge and given to all who could benefit. Care should not be used when it will not be beneficial. Effective care should be precise: services should not be overused or underused.
- Patient-centered: Care should be respectful and responsive to individual patient preferences, needs, and values.
- Timely: Access to care should not take longer than necessary. Patients should not have to wait unless it will provide information or time to heal. Prompt attention benefits both the patient and the caregiver.
- Efficient: Effective care should minimize waste — and cost — of supplies, equipment, space, capital, ideas, time, and opportunities.
- Equitable: Everyone should have access to high quality care, regardless of their race, ethnicity, gender, or income.
Our mission and vision
Our vision is to help create a world in which all people live healthier lives. We strive to create a better health system by removing barriers, providing no-nonsense solutions, innovating through partnerships, and delivering compassionate experiences.About Mass General Brigham
From the hospital to home, our integrated health system offers high-quality care in every part of the health journey. For more information, please visit massgeneralbrigham.org.Search among Mass General Brigham Health Plan jobs
| Jobs: 1 - 10 of 26 |
Benefits and Coding Administrator
Somerville, Massachusetts
Mass General Brigham Health Plan
This role supports the accurate and effective implementation of benefits across all products. It's primarily responsible for benefit configuration and ensuring the configuration aligns with business requirements. Acting as a subject matter ...
3h
| Job Type | Full Time |
Dual Eligible Program Inside Sales Rep
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for engaging prospective and existing customers through inbound and outbound communications, identifying their insurance needs, and recommending tailored solutions that align with our product offerings. Essential Functions -Cond...
9h
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Clinical Operations Manager will work closely with the Director, Clinical Performance Strategy & Support to manage vendor operations and strategic and high-visibility initiatives within the Clinical department. Essential Functions -Mana...
9h
| Job Type | Full Time |
Commercial Claims Operations Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
The Claims Operations Manager is responsible for managing commercial claims operations to ensure efficient and accurate processing of claims. Oversees claims workflows, compliance, and team performance to support revenue cycle goals and opt...
1d
| Job Type | Full Time |
DSNP Utilization Management Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
The D-SNP UM Case Manager, RN performs utilization management activities primarily for D-SNP (OneCare and Senior Care Options), including review of integrated organization determinations for outpatient, inpatient, post-acute, and long-term ...
2d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review. The ideal candidate will have prior author...
2d
| Job Type | Full Time |
Customer Service Representative
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity The Customer Service Professional (CSP) acts as the primary point of contact for our members, providers and other key stakeholders focusing on exceptional customer satisfaction and first call resolution. The CSP's interact w...
2d
| Job Type | Full Time |
Care Management Compliance Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
The Care Management Operational Compliance Manager reports to the Director of Clinical Operational Compliance and collaborates closely with the Legal, Regulatory Affairs, and Compliance (LRAC) department. They will work directly with care m...
2d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for evaluating and analyzing group insurance experience and community-rated fully and self-insured accounts. This role involves assessing the financial and operational aspects of group insurance proposals to determine coverage e...
3d
| Job Type | Full Time |
Quality Improvement Specialist
Somerville, Massachusetts
Mass General Brigham Health Plan
The Quality Project Management Specialist is responsible for coordinating and managing projects aimed at improving the quality of care, ensuring compliance with regulatory standards, and enhancing member satisfaction within the health plan....
3d
| Job Type | Full Time |