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 - 17 of 17 |
Regulatory Affairs Compliance Manager
Somerville, Massachusetts
Mass General Brigham Health Plan
Principal Duties and Responsibilities: *Works closely and collaboratively with Strategy, Sales, and Product Teams within Mass General Brigham Health Plan to ensure compliance with federal and state regulations in support of the overall Busi...
5d
Sr Clinical Pharmacist, Medicare and Duals
Somerville, Massachusetts
Mass General Brigham Health Plan
Principal Duties and Responsibilities: * Develop Medicare and Dual-eligible Custom Formularies: o Perform comprehensive analysis of pharmacy data (including but not limited to claims, competitor comparisons, trend analysis and market data) ...
5d
Appeals & Grievances Coordinator
Somerville, Massachusetts
Mass General Brigham Health Plan
The incumbent will coordinate, process, and document all aspects of member appeals and grievances across all of our Government Program product offerings (Medicaid and Medicare). Responsible for documenting and owning the life cycle of all m...
5d
Somerville, Massachusetts
Mass General Brigham Health Plan
Responsible for researching and resolving disputes (contracts, corrected claims, filing limits, authorization and payer policy etc.) for providers, members and internal customers. Will coach and mentor claims resolution staff, as well as di...
5d
Somerville, Massachusetts
Mass General Brigham Health Plan
As a direct contributor with no direct reports, the Solutions Architect works closely with customers, business analysts, and team members to understand complex business requirements that drive the analysis and design of effective technical ...
5d
Senior Ancillary Contract Manager, OneCare and Senior Care Options
Somerville, Massachusetts
Mass General Brigham Health Plan
This is a hybrid role that requires regular travel to provider sites and occasional onsite team meetings. The Senior Ancillary Contract Manager - OneCare & Senior Care Options (SCO) is responsible for the successful evaluation, negotiation,...
5d
Clinical Appeals and Grievances Nurse
Somerville, Massachusetts
Mass General Brigham Health Plan
While a remote role, this team meets every other month 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 4-6 weeks). The ...
5d