Provider Network Management Jobs in Massachusetts

INTRODUCTION

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 the coordination and overall tracking of the provider enrollment process.

Does this position require Patient Care? No

ESSENTIAL FUNCTIONS

• Reviews and screens all credentialing applications for completeness, accuracy, and compliance with federal, state, local, and company regulations, guidelines, policies, and standards.
• Ensures primary source verification and that all documents are accurate and complete relative to credentialing standards.
• Problem-solves discrepancies, time gaps, and other idiosyncrasies that could adversely impact the ability to credential and enroll practitioners.
• Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.
• Reviews reports and scoring required by regulatory and accrediting agencies, policies, and standards.
• Provides guidance and supervision of specialists throughout the credentialing process.

QUALIFICATIONS

Education

Associate's Degree Related Field of Study preferred or Bachelor's Degree Related Field of Study preferred

Can this role accept experience in lieu of a degree? Yes

Licenses and Credentials

Experience

Medical Office/Healthcare Experience 5-7 years required, and Provider Enrollment Experience 3-5 years required

Knowledge, Skills and Abilities

• Knowledge of provider enrollment policies, processes, procedures, and documentation.
• Ability to use independent judgment and to manage and impart confidential information.
• Skill in establishing priorities with independent coordination of day-to-day aspects.
• Ability to communicate effectively both orally and in writing.
• Strong organizational and project management skills.

ADDITIONAL JOB DETAILS (IF APPLICABLE)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$19.81 - $28.30/Hourly

Grade

3

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO STATEMENT:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

MASS GENERAL BRIGHAM COMPETENCY FRAMEWORK

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.