Mass General Brigham Health Plan Holding Company, Inc.
Boston, Massachusetts, United States
Base: $285,000.00 to $325,000.00 annually; bonus/e...
Fully remote
Active massachusetts physician license
3-5 years health plan experience
Utilization management expertise
This role leads medical management leadership for clinical services operations and programs within Mass General Brigham Health Plan
Job Summary
This role leads medical management leadership for clinical services operations and programs within Mass General Brigham Health Plan.
The position requires expertise in utilization management, health plan quality, accreditation, and care management functions.
Candidates will collaborate with business development, quality, finance, and medical management teams to improve care quality and cost efficiency.
Matching Summary
This role leads medical management leadership for clinical services operations and programs within Mass General Brigham Health Plan.
Salary
Base: $285,000.00 to $325,000.00 annually; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement, differentials, premiums, and bonuses included
Skills & Requirements
Must-have
Active Massachusetts physician license
3-5 years health plan experience
Utilization management expertise
Peer to peer discussion skills
Quality and accreditation knowledge
Nice-to-have
Experience with MassHealth and Medicare
Strong collaboration with business teams
Ability to handle appeals and grievances
Commitment to patient-first culture
Key Requirements
Full active Massachusetts physician license
3-5 years of Health Plan experience
Prior experience in utilization management
Experience with peer to peer discussions
Work Rights
Must have or be able to obtain MA physician license