4 branch manager jobs found in Somerville, MA

Site: Mass General Brigham Health Plan Holding Company, Inc.   Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.   MGB Health Plan is hiring two RN Transitions of Care Coordinators! Team: Whole HealthCare Duals Mass General Brigham Health Plan Hybrid: Required to travel in the community Primarily serves enrollees in the One Care and Senior Care Options (SCO) programs. Onsite to assess member patient following member (MGB hospital and facility or nursing home) Working with interdisciplinary team and liaison with all facilities. Assists with...

Site: Mass General Brigham Health Plan Holding Company, Inc.   Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.     Job Summary The Appeals and Grievance Coordinator will coordinate, process, and document all aspects of member appeals and grievances, as well as provider appeals across all our product offerings (Commercial, Medicaid and Medicare). This role will be responsible for documenting and guiding the life cycle of all member appeals and grievances and provider appeals. This includes, but is not limited to, maintaining tracking...

Site: Mass General Brigham Health Plan Holding Company, Inc.   Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.     Job Summary Responsible for supporting programs through the end-to-end processes of data management and data submissions. This will be accomplished through designing, building and automating reporting analysis and modeling by utilizing a variety of systems. Essential Functions -Perform analysis and reporting activities relating to: risk score calculation, claims/encounters data submission, chart review programs, audits, and...

Site: Mass General Brigham Health Plan Holding Company, Inc.   Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.     Job Summary 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 authorization (outpatient review) experience in a managed care setting with Medicaid/MassHealth knowledge. Principal Duties and Responsibilities: • Expertise in clinical review for...