| Do you want to work for a progressive company and enjoy a competitive salary and excellent benefits? If this sounds like a company you’d be interested in working for, send us your cover letter letting us know which opening you’re applying for and include an updated resume. We’re happy to accept your information in any of the following methods.
Mail: Health New England, Human Resources, One Monarch Place, Suite 1500, Springfield, MA 01144-1500
Fax: (413) 233-2747
E-mail: humanresources@hne.com
For more details on the openings that interest you, please check below.
Bi-Lingual Service Coordinator
Case Manager
Communications Coordinator
Medical Director
Member Services Representative
Provider Claims Representative
Bi-Lingual Service Coordinator
Position Summary:
Act as primary resource and contact for providers relating to service requests and correspond with members and providers as to decision(s) made regarding requests for these services. Assist Case Managers with research and correspondence related to service requests. Adhere to all HNE, HIPAA, DOI and NCQA standards, policies and procedures relating to member confidentiality, documentation, quality, and turn around times.
Qualifications:
The successful candidate will have a high school diploma plus 1-3 years experience in a medical administrative role in a physician's office, clinic or other medical facility or the insurance industry.
Additional skills include:
- Certified Medical Assistant preferred
- Experience with and/or specific training in medical terminology
- Excellent written and verbal communication skills in both English and Spanish
-
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >
Case Manager
Position Summary:
The Case Manager will deliver utilization management (UM), case management (CM) and disease management (DM) services to members in compliance with current accreditation requirements and quality standards, and within the scope of the members' benefit package and per HNE UM, CM, and DM policies. Support the HNE mission by developing partnerships with and providing personal and accountable service to members and providers. Impact positive health outcomes for members and positive financial outcomes for HNE.
Qualifications:
The successful candidate will have:
- RN with a current Massachusetts license
- 3-5 years experience required
- BSN preferred; CMM preferred
Additional skills include:
- Experience as a case/care manager, utilization management nurse, or health coach in managed care, home care, or hospital setting preferred
- Knowledge of chronic health conditions preferred
- Experience in patient education working with individual patients required
- Excellent written and verbal communication skills including a willingness to deliver presentations
- Sound clinical assessment and decision making skills
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >
Medical Director
Position Summary:
The Medical Director will have responsibility for utilization management and quality improvement for the delivery system. Other responsibilities include working with physicians to improve performance and utilization. The Medical Director also participates in physician recruitment, peer activity, credentialing, clinical advisory healthcare teams, and utilization review. The Medical Director shall function as a consultant representing the medical department to internal and external customers, including providers, employers and brokers.
Qualifications:
The successful candidate will have:
- A Medical Degree with board certification, holding an active, unrestricted license to practice, with a minimum of 5 years post-residency clinical/direct patient care experience
- Advanced Management Training
- Practical experience in health care administration and managed care experience desirable
Additional skills include:
- Demonstrated knowledge of the regulatory environment of managed care
- Excellent clinical, analytical, and facilitation and negotiation skills
- Must show evidence of leadership skills and possess excellent interpersonal skills required to interact with associates and customers.
- Able to exercise good judgment in problem solving and decision-making situations
- Excellent presentation, oral and written communication skills
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >>
Member Services Representative
Position Summary: To provide excellent customer service in response to member calls to HNE’s Member Services Call Center. Provide prompt, accurate, and complete benefits information to members, conducting additional research and follow-up as necessary.
Qualifications:
The successful candidate will have:
- Excellent verbal and written communication skills
- Problem resolution skills
- Solid interpersonal and negotiation skills
Associates Degree in Business Administration and at least two years of previous customer service/call center experience within the managed care or insurance industry preferred.
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >
Provider Claims Representative
Position Summary:
The Provider Claims Representative acts as HNE's Claims Department's liaison to our provider community. This individual interacts with provider offices regarding claims status, claims history, and verification of adjudication in a professional and courteous manner.
Qualifications:
The successful candidate will have:
- High school diploma
- Minimum of 3-5 years experience adjudicating health insurance claims, including good knowledge of relevant insurance policies, procedures, guidelines, and insurance eligibility determination
- Knowledge of applicable federal and state laws, regulations, and requirements or an equivalent combination of education and experience
Additional skills include:
- Excellent analytical, research, and problem resolution skills
- Excellent interpersonal and communication skills
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >
Communications Coordinator
Position Summary:
The Communications Coordinator determines whether proposed benefit and plan changes are consistent with operational practices, identifies particular problems, and reports them to the Communications Manager. Responsibilities include preparation and distribution of communications materials in a manner consistent with regulatory and accreditation requirements and customer expectations.
Qualifications:
The successful candidate will have:
We are committed to the people we serve, our providers and our community.
For consideration, please e-mail your resume and Curriculum Vitae to: humanresources@hne.com or mail to: Human Resources, Health New England, One Monarch Place, Suite 1500, Springfield, MA 01144-1500, fax: (413) 731-5275.
EEO – SMOKE FREE ENVIRONMENT
back to top >
|
