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Current Openings:

Health Plans offers an excellent working environment and a competitive wage/benefit package. If you are interested in any of the following positions, please email or fax your cover letter and resume to:

Email: jobs@healthplansinc.com

Fax: 508-329-4814

Case Manager

Department: Care Management Services

Location: Westborough, MA or Remote

Description: The Case Manager is responsible for the coordination of services and cost effective management of health care resources to meet individual members' health care needs and promote positive health outcomes. Will communicate with members/designees, physicians and other health care professional regarding the care management process including information about the role of Health Plans, Inc., the case management program, policies and procedures, benefit coverage, and determinations. 

The ideal candidate will be a Registered Nurse with a valid license in Massachusetts, Maine or New Hampshire. Bachelor’s Degree in Nursing and/or Certified Case Manager preferred. Must have 5 – 7 years’ experience in discharge planning and/or case management that include 3+ years’ in clinical settings. Must have familiarity with URAC, DOL and state/federal regulations; knowledge of CPT and ICD 10 coding a plus.

Must work collaboratively with other departments to resolve issues, have strong decision and problem-solving skills, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required.

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Contracts Administrator

Department: Corporate Compliance

Location: Westborough, MA

Description: Responsible for contracts administration utilizing writing, analytical, organizational, administrative skills and working knowledge of state and federal regulations to ensure that all contract functions of the Corporate Compliance Department related to clients’ Employee Health & Welfare Plans are performed in a timely, efficient and accurate manner.

The ideal candidate will have a Bachelor’s Degree and 5 – 7 years’ of experience in health plan administration, employee benefits, or benefit plan compliance in the healthcare industry with Health and Welfare Benefit Plan document drafting experience.  Must be able to understand and interpret plan documents and amendments, be detailed, organized and accurate, able to prioritize tasks and work within timeframes to meet deadlines, recognize and maintain confidentiality, and communicate effectively with all levels of staff.  Proficiency with Microsoft Word and Excel required. 

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Enrollment Specialist

Department: Enrollment

Location: Westborough, MA

Description: The Enrollment Specialist is responsible for timely, accurate entry of enrollment activity for all of Health Plans Inc.’s accounts.  The Specialist will interact directly with coworkers within the department as well as with various staff members from other departments.  Will process enrollment data via variance reports generated from 834 file transmissions, paper and email submissions, and transactions submitted through multiple databases (WebECI and CSIPac).

The ideal candidate will have a High School Diploma or equivalent; prior experience in healthcare industry or an enrollment position preferred.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required. 

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Funding Specialist

Department: Fund Accounting

Location: Westborough, MA

Description:  The Funding Specialist is responsible for coordinating daily account activity for employer groups who self-fund their health, dental and short-term disability benefits programs. As such, the Specialist manages information for clients in the areas of funding, billing and reporting.

The individual must communicate effectively, both verbally and in writing; work independently, be detailed, analytical, accurate and recognize the need for follow-thru and follow-up as well as possess the ability to work within specified timeframes and meet deadlines.

The ideal candidate will have a High School Diploma or equivalent. Must have at least 2 years’ experience in a customer service/call center environment, preferably in the healthcare industry. Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required.

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Customer Support Specialist

Department: Customer Service

Location: Quincy, MA

Description:  The Customer Support Specialist is responsible for providing high quality customer service to members, providers and other customers of Health Plans, Inc.  The Customer Support Specialist handles inbound calls regarding questions on medical, dental and other benefits.

The ideal candidate will have a High School Diploma or equivalent; 1 – 2 years’ prior customer service in the healthcare industry preferred.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required.

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Customer Support Specialist

Department: Customer Service

Location: Westborough, MA

Description:  The Customer Support Specialist is responsible for providing high quality customer service to members, providers and other customers of Health Plans, Inc.  The Customer Support Specialist handles inbound calls regarding questions on medical, dental and other benefits.

The ideal candidate will have a High School Diploma or equivalent; 1 – 2 years’ prior customer service in the healthcare industry preferred.  Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within timeframes and meet deadlines, recognize and maintain confidentiality, and communicate in a professional manner.  Proficiency with Microsoft Word and Excel required.

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Compliance & Privacy Specialist

Department: Compliance

Location: Westborough, MA

Under the direction of the Director of Compliance and Privacy Officer, the Compliance and Privacy Specialist will assist with managing, developing, implementing and monitoring a comprehensive Compliance and Privacy Program in accordance with Health Plans’ policies and federal and state requirements and guidance. The Specialist will work collectively with the Director, senior leadership, and subsidiaries management to ensure that compliance and privacy initiatives are implemented appropriately. As directed, the Analyst will assist with leading efforts implementing, monitoring, and tracking Compliance and Privacy Program elements and providing direction and guidance to subsidiaries personnel for adherence to industry regulations, organization policies, Federal Sentencing Guidelines, HIPAA, and applicable federal and state requirements.

The ideal candidate will have a Bachelor’s Degree and the equivalent of 2 – 4 years’ of full-time experience with compliance, privacy, confidentiality, health information management, or information security in the healthcare industry. Advanced degree (e.g. JD, MHA, MPA, etc.) preferred. Will also possess the following:

  • Strong commitment to maintain confidentiality and privacy.
  • Knowledge of and experience in working with federal and state privacy laws, including those pertaining to access, release of information, and release control technologies.
  • Commitment and ability to:
    • Work in a team-based environment;
    • Handle member interactions/communication with extreme care, patience and consideration; and
    • Create an environment with open channels of communication within the organization with workforce members, members and others.
  • Possess excellent organization, attention to detail, facilitation, technical and analytical skills. Can gather relevant information systematically, break down problems into simple components and can make sound decisions.
  • Approach problems with curiosity and open-mindedness and offer new ideas, solutions and/or options. Demonstrate discretion, diplomacy, and good judgment.
  • Possess strong communication and presentation skills; clearly and concisely express ideas in groups and one-to-one conversations, formal and informal documents. Adapt writing and communications styles to fit the audience.
  • Project management and change management skills; ensuring projects come to fruition from inception to completion.
  • MS Office (Word, Excel, Access, PowerPoint) expertise and knowledge of or ability to learn electronic medical record auditing software.

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