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: 11 - 20 of 27 |
Supervisor Customer Service, Medicare Advantage
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for overseeing a team of customer service representatives, monitor call center operations, and provide guidance and support to ensure efficient and effective customer interactions. Essential Functions -Manage and supervise a tea...
5d
| Job Type | Full Time |
Business Intelligence 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...
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 |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity Mass General Brigham Health Plan seeks a Registered Nurse (RN) Clinical Care Manager to work as part of an interdisciplinary care team providing care management for health plan enrollees with complex medical, behavioral, and...
10d
| 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...
11d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity The Payment Policy Manager is vital to the team and responsible for developing, implementing, and managing payment policies and strategies by analyzing regulatory changes and reimbursement models to optimize revenue and ensu...
14d
| 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 ...
15d
| Job Type | Full Time |
Medicare Appeals and Grievances Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
While a remote role, this team meets every quarter at the office at Assembly Row in Somerville and attendance is highly encouraged. This role would also require on-call coverage on the weekends/holidays (currently every other weekend). The ...
17d
| 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...
17d
| Job Type | Full Time |
DSNP Claims Quality Control Reviewer
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for monitoring Quality Control (QC) of Claims Operations and the reporting of all metrics related to such activities. Essential Functions - Responsible for end-to-end pre-pay review of claims adjudicated in QNXT to ensure comple...
17d
| Job Type | Full Time |