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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

Reinsurance Analyst

Department: Reinsurance

Location: Westborough, MA

Description: The Reinsurance Analyst is responsible for calculating and submitting specific and aggregate filings to the reinsurance carriers. The Reinsurance Analyst will act as liaison between the reinsurance community and Health Plans, Inc.

The ideal candidate will have a High School Diploma or equivalent. Must have 1 - 2 years’ of processing experience, preferably within the self-insured health insurance industry. Must have knowledge of hospital and provider billing procedures; have the ability to interpret and understand plan document language and stop-loss contracts.

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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Claims Operations Manager

Department: Claims Operations

Location: Westborough

Description: Reporting to and working closely with the Director of Claims Operations, the Claims Operations Manager is responsible for the day-to-day management of the Claims Operations department with respect to the productivity, quality, and timely completion of all Claims Operations functions. The functions include claims inventory management, claims and adjustment processing, responding to member and provider appeals, claims quality assurance, and processing of vendor recoveries and payments. 

The manager is accountable for meeting Claims Operations goals/metrics for claims turnaround time, claims quality, timely response to member and provider appeals, and return check processing. The manager is responsible for the hiring, training and performance assessment and development of all Claims Operations staff. 

The ideal candidate will have a Bachelor’s Degree or equivalent experience, and five to ten years’ of experience in Claims Operations within the health insurance industry. Must have a successful track record of progressive supervisory/management experience. Must be able to strategically review department work, processes and responsibilities, and continuously identify changes or enhancements which will increase efficiency, productivity and quality; identify and understand root causes of problems and work to resolve them; and collaborate with other areas that depend on the work of Claims Operations and impact a customer’s experience and satisfaction.

Must be able to work independently and as part of a team, be detailed, organized and able to prioritize tasks, work within a production environment with specific timeframes and deadlines, recognize and maintain confidentiality, and communicate in a professional manner. Proficiency with Microsoft Word and Excel required. 

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Help Desk Support

Department: Information Systems

Location: Westborough

Description: This position maintains and provides hardware and software support and maintenance for servers, desktop workstations, network infrastructure, and users throughout the company. Duties include responding to requests for technical assistance (in person, via phone, or electronically) and advising user on appropriate action; diagnosing and resolving technical hardware and software issues; tracking/logging all help desk interactions; identifying and escalating situations as appropriate; preparing activity reports; and establishing and maintaining user profiles, directories, etc.

The ideal candidate will have a High School Diploma or equivalent; college degree preferred.  Three to five years’ of help desk support experience, preferably in the healthcare industry.  Must have basic networking, DNS, and DHCP knowledge. Must have a basic understanding of Active Directory and server operating systems. Candidates must 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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Accounting Support

Department: Corporate Accounting

Location: Westborough, MA

Description: The Accounting Support position will be responsible for a variety of diverse tasks and processes within the Corporate Accounting department. These tasks include reconciling FBO Account activity against bank statements and ARP files; preparing Santander Account Analysis spreadsheet; sorting checks daily; posting surcharge payments; preparing daily surcharge deposit tally; processing onsite check deposits to various accounts; updating spreadsheets for reconciliation; matching carrier remittance checks to invoice, and preparing wire spreadsheet and deposit; and copying, scanning and filing as needed.

The ideal candidate will have banking and/or finance experience, preferably in the healthcare industry. Candidates must 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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Claims Examiner

Department: Claims

Location: Westborough, MA

Description: The Claims Examiner is responsible for the processing of medical claims in accordance with applicable plan benefits. This position will handle of a specific block of group plans and is integral in maintaining the client/customer relationship with those group plans.  The Claims Examiner will also assist claimants, providers and/or clients with problems or questions regarding their claim and/or policies.

The ideal candidate will have a High School Diploma or equivalent; prior experience in claims processing, knowledge of medical terminology and/or billing and coding 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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Director, Stop Loss Program

Department: Stop Loss

Location: Westborough, MA

Description: Reporting to a member of the HPI Executive Team, the Stop Loss Program Director is responsible for managing the HPHC Stop Loss program’s long term success.  This individual is responsible for the P&L of the Stop Loss Program with a strong focus on growing membership and achieving established profitability targets. The Director will develop, manage and implement the strategic plan for the program.  These critical functions fall within the overall strategy and goals established by HPHC/HPI.  The Stop Loss Program Director will undertake these tasks in a manner that is consistent with the established values and core operating principles of the corporation.  This position will work very closely with HPI management, HPHC Underwriting and Actuarial, HPI and HPHC Sales, regional market leaders and functional leaders. 

The ideal candidate will have Bachelor’s Degree required; MBA, MHA, MS preferred.  Eight to ten years’ of experience in the self-funded and/or stop loss industry required.  Must have experience with complex matrixed responsibility in a large organization, and familiarity with a range of diversified product lines and competitor products.  Must be an effective leader and problem solver, be able to function independently as well as in a team, and act as an agent of change.  Must possess excellent communication skills, be proactive and innovative with strategic and business planning capabilities, organized, flexible, and display a positive attitude.  Ability to travel regularly to HPI and HPHC locations, as well as other locations as needed.  Proficiency in Microsoft Office Programs, including Word, Excel, PowerPoint and Outlook.

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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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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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