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 14 |
Director, Special Investigations Unit
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing insurance audits and investigations to ensure compliance with regulatory standards and protect the organization from financial risk. Manages audit processes, identifies potential fraud, and drives improvement in c...
4h
| Job Type | Full Time |
DSNP Marketing Program Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for driving strategic growth initiatives, identifying new business opportunities, and expanding market presence for the organization. Your primary focus will be on analyzing market trends, developing business plans, and implemen...
10h
| Job Type | Full Time |
Medicare DSNP Redetermination Coordinator
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for outreaching to members to assist them with the Medicaid Enrollment Redetermination process. This position is responsible for monitoring and optimizing processes related to Enrollment Redetermination. Essential Functions -Mon...
10h
| Job Type | Full Time |
Supervisor, Commercial Claims Reviewer
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing a team that assesses healthcare claims for accuracy, compliance, and eligibility, ensuring that claims are processed efficiently and in accordance with industry standards, regulatory requirements, and organization...
10h
| Job Type | Full Time |
Duals Supervisor, Appeals and Grievances
Somerville, Massachusetts
Mass General Brigham Health Plan
The Duals Supervisor, Appeals and Grievances provides day-to-day supervision of a team of 4-6 appeals and grievance coordinators and is ultimately responsible for the work product of this team and the Duals line of business. The Supervisor ...
4d
| Job Type | Full Time |
Epic Cogito & Analytics Developer
Somerville, Massachusetts
Mass General Brigham Health Plan
Under the direction of the Manager of Clinical Reporting and BI, Responsible for designing and implementing data analysis and reporting solutions to meet the data and reporting needs of the enterprise's clinical department. Work closely wit...
4d
| 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...
7d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for ensuring that all vendors and suppliers meet regulatory, quality, and performance standards. This role involves evaluating vendor performance, conducting audits, and collaborating with various departments to maintain high st...
7d
| Job Type | Full Time |
Utilization Management Care Manager
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...
7d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
An essential, non-clinical member of the care team that provides services for patients with substance use disorder (SUD). The overall goal is to engage with patients, utilize harm reduction techniques to address any stage of readiness, prov...
12d
| Job Type | Full Time |