Clinical Support Coordinator
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 health...

Medicare Advantage Project Coordinator (Remote)
Somerville, MA
Works with the Director, Medicare Advantage Program and Innovation Operations, and health plan business areas/departments to execute the annual Medicare Advantage work plan which include...

Customer Service Professional
Somerville, MA
Serve as the primary liaison for members and providers for all lines of business including MassHealth, and Commercial members regarding general program inquires such as eligibility verif...

Senior Actuarial Analyst
Somerville, MA
Supports reserving analysis and communication of financial results to senior leadership. Responsible for monthly IBNR and other actuarial accruals (MLR Rebate, risk adjustment, PDR, Prov...

Claims Resolutions Coordinator
Somerville, MA
Review and research assigned claims by navigating multiple systems and platforms and accurately capturing the data/information necessary for processing (e.g., verify pricing/Fee Schedule...

Sr. Information Mgt Developer
Somerville, MA
Information Management Developer Leads analysis, design, development, and testing of operational and regulatory reporting for Medicare and Medicaid lines of business. Produces data sets...

Sr. Data Analyst
Somerville, MA
Evaluate and analyze data using T SQL, Excel, and PowerBI and other BI tools to design, develop, and test analytic solutions from various data sources. Analyze, Interpret, and validate r...

Reconciliation Program Manager
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 c...

Medical Letter Writer
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 health...

Senior Product Manager
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...

Senior Staff Accountant
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 ledg...

Medicare Advantage Customer Service Team Leader
Somerville, MA
Ensures Medicare Advantage CSP guidelines and compliance with CMS regulations Identify trends within the Medicare Advantage team Provide daily direction to team members and ensure their...

Utilization Management Care Manager
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 health...

Senior Operations Analyst, Medicare Advantage Enrollment and Billing
Boston, MA
Execute internal auditing and quality monitoring for daily, monthly, and annual transactions related to beneficiary, enrollment/disenrollment, membership benefit status and premium payme...

Manager Appeals & Grievances
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 a...