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 |
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...
14h
| Job Type | Full Time |
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...
14h
| Job Type | Full Time |
Senior Medicare Compliance Program Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for leading and overseeing the development, implementation, and monitoring of the MGB Health Plan's Medicare compliance program. This role involves ensuring adherence to regulatory requirements, mitigating risks, and fostering a...
14h
| Job Type | Full Time |
Clinical Appeal and Grievance Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
The role is an integral part of our Appeals and Grievance review process and will ensure clinical/pharmacy appeal case reviews meet contractual, regulatory, and business goals. The position collaborates with members of the Appeal and Grieva...
14h
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Vendor Specialist will work closely with the Director, Partnerships and Alliances, and the Program Manager to ensure that all aspects of the vendor management lifecycle are managed in a coordinated, efficient, and organized manner. Impo...
14h
| Job Type | Full Time |
Medicare Utilization Management Supervisor
Somerville, Massachusetts
Mass General Brigham Health Plan
The supervisor will work closely with the Manager of Clinical, to oversee the daily operations of roughly 5 Medicare Advantage utilization management staff. The supervisor will be responsible for the direct coaching, supervision, and evalua...
3d
| 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...
5d
| 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...
9d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
MGB Health Plan is seeking an experienced EDI Developer responsible for the design, development, implementation, and ongoing maintenance of healthcare EDI solutions supporting HIPAA transactions, including but not limited to 270/271, 276/27...
9d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The role is an integral part of our Appeals and Grievance review process and will ensure clinical/pharmacy appeal case reviews meet contractual, regulatory, and business goals. The position collaborates with members of the Appeal and Grieva...
11d
| Job Type | Full Time |