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 28 |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity MGBHP is seeking an experienced EDI Developer who is responsible for the design, development and maintenance of EDI solutions for HIPAA EDI like 270/271, 276/277, 278, 820, 834, 835, 837 and 999 transactions. Must have a goo...
19h
| Job Type | Full Time |
Clinical Quality Program Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing and improving clinical performance metrics and ensuring compliance with healthcare regulations and accreditation standards. Collaborates with clinical teams to develop strategies for improving patient care outcome...
1d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Mass General Brigham Health Plan is hiring for two Behavioral Health Specialists to work as part of an interdisciplinary care team providing expert recommendations for managing behavioral health conditions and providing specialized coordina...
1d
| Job Type | Full Time |
Supervisor, Utilization Management
Somerville, Massachusetts
Mass General Brigham Health Plan
The supervisor will work closely with the Manager, Clinical, to oversee the daily operations of the utilization management staff. The supervisor will be responsible for the direct coaching, supervision, and evaluation of licensed clinical s...
1d
| Job Type | Full Time |
Medicare Supervisor Claims Reviewer
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing a team of 4-5 employees that assesses Medicare claims for accuracy, compliance, and eligibility, ensuring that claims are processed efficiently and in accordance with industry standards, regulatory requirements, a...
3d
| Job Type | Full Time |
Medicare Utilization Management Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
The Medicare UM Case Manager, RN performs utilization management activities primarily for Medicare Advantage, including review of authorizations for home care, high tech radiology, outpatient, inpatient, and post-acute services. The Medicar...
3d
| Job Type | Full Time |
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 ...
3d
| 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...
3d
| 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...
3d
| 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...
4d
| Job Type | Full Time |