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 13 |
Senior Vendor Compliance Program Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
In collaboration with the Senior Director, Government programs, manage the vendor oversight programs for government payer programs (Medicare Advantage, Part D, Dual Special Needs Programs) and then state insurance programs. Set up the vendo...
14h
| 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...
14h
| Job Type | Full Time |
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...
1d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing a team that assesses healthcare (D-SNP/fully-integrated Medicare & MassHealth/Medicaid) claims for accuracy, compliance, and eligibility, ensuring that claims are processed efficiently and in accordance with indus...
6d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The role is responsible for investigating potential recoveries for Coordinaton of Benefits through phone calls, questionnaires, claims, provider inquiries, and other systems as required. This incumbent will also be responsible for the manag...
6d
| Job Type | Full Time |
Medicare Advantage Call Center/Enrollment Quality Reviewer
Somerville, Massachusetts
Mass General Brigham Health Plan
The Quality Control Reviewer for Medicare Advantage and DSNP is a vital member of the quality assurance team, focused on monitoring and evaluating Medicare Advantage and DSNP customer service calls, transactions, and member enrollment proce...
7d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Summary Responsible for providing, designing, developing, testing, implementing and ongoing maintenance of new and existing software applications. This role also provides training and support to end users. Essential Functions -Reviews syste...
7d
| Job Type | Full Time |
Member Enrollment Representative I
Somerville, Massachusetts
Mass General Brigham Health Plan
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Togeth...
7d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Togeth...
8d
| Job Type | Full Time |
Sr Business Intelligence Development
Somerville, Massachusetts
Mass General Brigham Health Plan
Summary Utilize Microsoft Business Intelligence tools, primarily Microsoft SSMS, SSAS, SSIS and PowerBI, to develop and support operational, clinical, and financial analysis. Support Data Scientists on the team with Microsoft SQL queries an...
9d
| Job Type | Full Time |