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 22 |
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...
4h
| 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...
16h
| 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...
16h
| Job Type | Full Time |
Claims Review Specialist, DSNP
Somerville, Massachusetts
Mass General Brigham Health Plan
The D-SNP Claims Review Specialist processes Senior Care Options and One Care medical claims that do not auto-adjudicate through the claim system, adhering to Mass General Brigham Health Plan's current administrative policies, procedures, a...
16h
| 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...
22h
| 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...
2d
| Job Type | Full Time |
Sr Business Intelligence Developer
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity The Sr Business Intelligence Developer is vital to the team! You will use Microsoft Business Intelligence tools, primarily Microsoft SSMS, SSAS, and SSIS to maintain BI data structures in support of operational, clinical, an...
4d
| Job Type | Full Time |
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity 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 spec...
4d
| Job Type | Full Time |
RN Transitions of Care Coordinator
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity Mass General Brigham is hiring two Transitions of Care Coordinators to work as part of an interdisciplinary care team dedicated to supporting enrollees and their families in navigating the healthcare system through effective...
4d
| Job Type | Full Time |
Care Guide Resource Specialist
Somerville, Massachusetts
Mass General Brigham Health Plan
The Opportunity Mass General Brigham Health Plan is hiring two Care Guides to actively participate with the Interdisciplinary Care Team (ICT) and serve as an additional point of contact for enrollees. This role involves proactive outreach a...
4d
| Job Type | Full Time |