Account Specialist at Mass General Brigham

Site: Mass General Brigham Community Physicians, 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 Account Specialist is responsible for supporting the Account Managers in their efforts to resolve a wide variety of contractual, operational, and strategic issues as quickly and efficiently as possible. Through the Account Managers, the Account Specialist will help implement network-wide strategic initiatives throughout the MGB CP Network to enhance their organizational, operational, and financial effectiveness.

The Account Specialist will work closely with MGB CP, PHSO, OCMO, external payers and other internal and external resources to facilitate a successful and timely resolution to issues that require additional research and have been escalated by the Account Managers, RSO leadership and practices within the CP. The Account Specialist builds a strong relationship internally and externally to help support the Account Managers.

Qualifications Education:

• Bachelors Degree in finance preferred

• Equivalent experience may be accepted in lieu of degree

Experience:

• 2+ years of back-office healthcare industry experience, with increasing responsibilities and autonomy.

• 2+ years of experience in a healthcare setting, such as a Management Services Organization (MSO), a Physician Hospital Organization (PHO) or a health plan strongly preferred

• Position requires a high level of judgment, creative problem solving, independence, comfort, and experience with interfacing with Manager and Director level staff. Experience in working within a team is critical.

Knowledge/Skills/Abilities

• Knowledge and understanding of the healthcare industry, including but not limited to medical management, financial, operational and organizational components.

• Able to synthesize data from multiple sources, identify trends and key issues from the data, and deliver a succinct message to RSO and MGB CP leadership.

• Strong understanding of payer operations.

• Basic understanding of finance and accounting principles with the ability to understand various fund flow models.

• Ability to simultaneously handle a variety of complex issues.

• Ability to work collaboratively within a team environment.

• Navigate within a highly matrixed organization.

• Recognize politically sensitive issues yet remain effective at the task at hand.

• Know when and how to escalate issues.

• Strong judgment and discretion skills.

• Skillful in analyzing situations accurately and taking effective action.

• Skillful in establishing and maintaining effective working relationships with MGB CP, PHM, OCMO, RSO and Practice leadership.

• Organized and able to manage and prioritize multiple projects with competing priorities, often with little direct supervision or initial guidance.

• Must have ability to adapt to changing environment.

• Understanding of the functions and uses of database management systems.

• Intermediate to advanced skills with Microsoft Excel, Access, PowerPoint, and Word.

• Excellent oral and written communications skills, with the ability to effectively analyze and interpret complex data.

• Willingness to travel to practices as needed. Access to a vehicle and a valid driver’s license is required.

• Other duties as assigned.

Relationship Management

• Alongside the Account Manager, serve as a liaison and a bi-directional channel of communication between leadership at MGB CP, community RSOs, AMCs, and PHSO/OCMO.

Working closely with Account Managers to:

• Act as an RSO voice within MGB CP to promote community interests, raising critical issues to the Account Manager to address and help support successful resolutions.

• Develop new relationships and enhance existing ones internally at MGB as well as externally.

• Support distinct needs of the affiliate practices.

• Attend RSO meetings as appropriate.

• Build relationships with MGB Contracting, RCO as well as external payors to ensure timely responses to RSOs need.

Provide Operational Support

• Escalate and troubleshoot payer-related policies, contractual, operational, and technical issues by working collaboratively with internal MGB departments, such as Contracting, Finance, and Provider Enrollment.

• Assist in researching and resolving:

• Payer claim payment issues.

• Benefit and copayment questions.

• Balance billing issues.

• Supplemental payment questions.

• Summarize payer-related issues that need to be escalated and discussed at Payer Operation meetings.

• Focus on operational effectiveness.

• Provide general behind the scenes support to RSOs on IPF related issues.

• Maintain full knowledge of IPF measures, including an understanding of the measures.

• Maintain a general understanding of the differences between payers and products.

• Maintain Account Management Grid.

• Help distribute reports to the RSO/practices as needed.

• Maintain accurate and up-to-date documentation of practice and provider information across all internal systems.

• Prepare and distribute regular status updates and reports on payer enrollment progress and provider onboarding.

Payer Enrollment for Direct Affiliate Practices

• Works closely with the RCO enrollment team to onboard and offboard MGB CP direct affiliates.

• Collects completed paperwork.

• Acts as a conduit to provider enrollment.

• Monitor payer enrollment timelines and escalate delays or issues when needed to ensure timely provider activation.

Support various MGB CP led meetings

• Support various MGB CP led meetings by:

• Scheduling.

• Help setting agenda.

• Collecting presentations and creating the slide deck.

• Pre and post meetings with each of the teams.

• Keeping the meeting on schedule.

• Taking minutes.

• Assist the Senior Medical Director on ad hoc requests.

Work Environment:

Remote, in office 1-2 times a year if necessary. At the corporate office, work is done in an open area with other employees. Workstation is a cubicle. Occasional lifting/pushing/pulling/carrying up to 5 pounds with 10 pounds maximum. Opportunity for mobile work 3-4 days per week.

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

$53,040.00 - $75,888.80/Annual

Grade

5

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:

6010 Mass General Brigham Community Physicians, Inc. 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.