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 23 |
RN Transitions of Care Coordinator
Somerville, Massachusetts
Mass General Brigham Health Plan
Mass General Brigham Health Plan is hiring an RN Transitions of Care Coordinator to work as part of an interdisciplinary care team dedicated to supporting SCO and OneCare members and their families in navigating the healthcare system throug...
2d
| 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...
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...
8d
| Job Type | Full Time |
Third Party Liability Representative
Somerville, Massachusetts
Mass General Brigham Health Plan
The Third-Party Representative will be responsible for investigating potential recoveries for third party liabilities through phone calls, questionnaires, claims, provider inquiries, ISO net, and other methods as required. This person will ...
8d
| 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...
8d
| 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...
9d
| 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...
9d
| 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...
13d
| Job Type | Full Time |
Care Management Compliance Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
The Care Management Operational Compliance Manager reports to the Director of Clinical Operational Compliance and collaborates closely with the Legal, Regulatory Affairs, and Compliance (LRAC) department. They will work directly with care m...
13d
| 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...
14d
| Job Type | Full Time |