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Reconciliation Program Manager
Mass General Brigham Health Plan
-
Somerville, MA
Responsible for ensuring all 834 transactions are being correctly reconciled. Work closely with IT to set requirements and user stories, as well as signing off on results and approving changes being promoted to production. Lead teams to enable system automation in Enrollment to reduce administrative costs, improve member experience and operational efficiency. Engage, empo
Email Job
Posted 1 day ago
Actuarial Analyst II
Mass General Brigham Health Plan
-
Somerville, MA
Leads reserving analysis and communication of financial results to senior leadership. Responsible for developing monthly IBNR, reviewing claims projects, updating lag files, and supporting of other actuarial accruals (MLR Rebate, MassHealth Corridors and Settlements, Risk Adjustment, Cost Sharing Reduction Accrual, etc.) Supports the quarterly forecasting of Mass General
Email Job
Posted 1 day ago
Medical Letter Writer
Mass General Brigham Health Plan
-
Somerville, MA
This is a remote role with occasional (roughly 1x/every other month) onsite team meetings in Somerville, MA. Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our
Email Job
Posted 4 days ago
Senior Product Manager
Mass General Brigham Health Plan
-
Somerville, MA
This is a hybrid role that will require an onsite presence to the office 1x/month Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative sol
Email Job
Posted 4 days ago
Supervisor, Government Programs Utilization Management
Mass General Brigham Health Plan
-
Somerville, MA
This is a remote role with occasional (roughly 1x/every other month) onsite team meetings in Somerville, MA. Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our
Email Job
Posted 8 days ago
Senior Staff Accountant
Mass General Brigham Health Plan
-
Somerville, MA
Responsible for all journal entries, monthly account reconciliations, and transactions for assigned accounts. Responsible for the timely creation and verification of monthly general ledger entries. Manages MassHealth Accountable Care Organization transactions and reporting. Works with senior finance staff to review financial documents and perform income and expense analys
Email Job
Posted 9 days ago
Regulatory Manager, Behavioral Health
Mass General Brigham Health Plan
-
Boston, MA
Act as a subject matter expert in mental health parity, which will include, having a strong understanding of the current state and federal laws, as well as best practices that can address and close any mental health parity gaps. Provide expertise in the area mental health parity and provide language and/or operational recommendations that will reduce mental health parity
Email Job
Posted 9 days ago
Senior Operations Analyst, Medicare Advantage Enrollment and Billing
Mass General Brigham Health Plan
-
Boston, MA
Execute internal auditing and quality monitoring for daily, monthly, and annual transactions related to beneficiary, enrollment/disenrollment, membership benefit status and premium payment reconciliation. Develop subject matter expertise of complex Medicare/Medicaid program eligibility, and train others as needed. This will include developing and managing a quality assura
Email Job
Posted 9 days ago
Manager Appeals & Grievances
Mass General Brigham Health Plan
-
Boston, MA
Hold self and others accountable to meet commitments. Ensure diversity, equity, and inclusion are integrated as a guiding principle. Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people first organization.
Email Job
Posted 9 days ago
Sr. Correspondence Coordinator
Mass General Brigham Health Plan
-
Somerville, MA
For over 30 years, AllWays Health Partners has delivered value to our members and worked to improve access to care and coverage. As a member of Mass General Brigham, AllWays is a health plan at the forefront of innovation, advancing a highly integrated model of value based care with one of the world's leading health care systems. Together, we are transforming the customer
Email Job
Posted 9 days ago
Supervisor, Medicaid Claims Reviewer
Mass General Brigham Health Plan
-
Somerville, MA
Supervise the Claims Review Team in compliance with Mass General Brigham Health Plan's policies and procedures including Train, motivate, develop and evaluate staff in compliance with established policies, practices and procedures. Set and approve work schedules, time off requests, overtime and approve timecards. Schedule staff for needed training and development. Mentor
Email Job
Posted 9 days ago
Medicare Product Manager
Mass General Brigham Health Plan
-
Somerville, MA
Deep understanding of Medicare products and CMS rules and regulations governing those products. Ability to lead cross functional teams, drive decision making and ensure end to end operational integrity of product implementations and/or product enhancements Drives secondary research and qualitative and quantitative analysis to inform product design and development Assists
Email Job
Posted 9 days ago
Municipal Manager
Mass General Brigham Health Plan
-
Somerville, MA
Responsible for managing municipal and labor related activities for Mass General Brigham Health Plan. The scope of this position encompasses strategic growth plans for the municipal and labor market. Including broker/consultant relationship management, Chapter 32B municipal processes and procedures, product development and placement for active and retirees. Strong underwr
Email Job
Posted 9 days ago
Manager, Financial and Regulatory Reporting
Mass General Brigham Health Plan
-
Somerville, MA
Assist with monthly general ledger close, reporting, and general ledger account reconciliations. Deliver timely and accurate financial reporting data to internal and external customers while successfully executing on financial reporting controls. Monitor executing and documenting key controls and policies & procedures, including, but not limited to regulatory filings, man
Email Job
Posted 9 days ago
Vendor Manager
Mass General Brigham Health Plan
-
Somerville, MA
Reviews and negotiates terms of vendor contracts and communicates with vendors regarding day to day matters. Responsible for onboarding of new vendors from requirements gathering to go live and post go live. Works with internal stakeholders during onboarding phase to ensure successful launch. Builds and maintains positive relationship with vendors and monitor vendor perfo
Email Job
Posted 9 days ago
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