Care Guide Resource Specialist

Site: Mass General Brigham Health Plan Holding Company, 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. Mass General Brigham is hiring for two open spots: Care Guide / Resource Specialist I Full Time with

benefits:

! Mass General Brigham Health Plan Coordinated Whole HealthCare Duals Team This fully remote position primarily serves enrollees enrolled in the One Care and Senior Care Options (SCO) programs, focusing on populations residing in Essex, Middlesex, Suffolk, Norfolk, Plymouth, Bristol, Dukes, and Nantucket counties.

Job Summary The

Opportunity:

Mass General Brigham Health Plan is hiring two Care Guides to actively participate with the Interdisciplinary Care Team (ICT) and serve as an additional point of contact for enrollees. This role involves proactive outreach and timely responses to inbound inquiries and service requests, with the primary objective of helping enrollees access their insurance

benefits:

and obtain the care they need—ultimately simplifying and enhancing their healthcare

experience:

The Care Guide supports enrollees by assisting them in identifying a primary care provider (PCP) when necessary, coordinating follow-up appointment scheduling, and providing reminders for upcoming lab tests and medical visits to encourage adherence to care plans. Additionally, the Care Guide is responsible for closing care gaps by reviewing enrollee medical data, facilitating the scheduling of overdue appointments and screenings, and collaborating closely with providers and the ICT to ensure comprehensive care management.

Responsibilities:

and caseload may be adjusted in response to changes in enrollee enrollment trends. Essential Functions • Proactively contacts enrollees to schedule and remind them of upcoming appointments, overdue screenings, pre-visit labs, and conducts ongoing check-ins to assess their needs.

• Closes care gaps by analyzing data from electronic health records, enrollee registries, claims, and care team information to drive outreach and improve quality measures and performance outcomes.
• Establishes and maintains positive relationships with local practice teams, community-based organizations, and vendors to support enrollee needs and facilitate coordinated care.
• Coordinates tailored outreach strategies for populations requiring chronic disease management and preventive care, ensuring efficient communication and avoiding duplication with plan and practice outreach efforts.
• Assists enrollees in accessing plan

benefits:

, overcoming barriers to care, finding primary care providers, scheduling appointments, and navigating healthcare services.

• Supports service request management, authorization monitoring, and compliance adherence.
• Participates in multidisciplinary population health initiatives focused on reducing disparities and enhancing care quality.
• Follows established communication protocols and provides updates to clinical teams, health plan staff, and leadership as needed.
• Contributes to quality improvement initiatives, the design of population health processes, and performs additional duties as assigned by the supervisor.

Qualifications:

High School Diploma or Equivalent required Associate's Degree Related Field of Study preferred Bachelor's Degree Related Field of Study preferred Field of Study: social sciences or health management or the equivalent Minimum 2 years in direct healthcare delivery systems or relevant work

experience:

within care required Related

experience:

2-3 years preferred

Experience:

with Medicare and Medicaid preferred Bilingual candidate highly preferred, English and Spanish, Portuguese, French, and/or Chinese Competent in working with multiple healthcare computer platforms, with EPIC

experience:

considered a plus, and able to work effectively in a fast-paced medical environment across multiple practice locations. Field of Study: with significant relevant work

experience:

may be substituted for a portion of the degree

Experience:

d in supporting individuals with complex medical, behavioral, and social needs, utilizing knowledge of healthcare and community services to assist enrollees effectively. Strong customer service

skills:

with a positive, friendly, kind, and patient demeanor to engage enrollees and interdisciplinary teams effectively, combined with excellent oral, written, and telephonic communication abilities.

• Demonstrates critical thinking, problem-solving

skills:

, and autonomy in decision-making while maintaining strong organizational

skills:

to manage routine work, triage, and reset priorities as needed. Exhibits strong interpersonal

skills:

to work collaboratively with providers and their staff, building rapport and trust to promote Population Health initiatives. Comfortable with change and adaptable, able to pivot as part of continuous process improvement activities, working independently while contributing to a collaborative team environment.

Skills:

and Abilities Familiarity with medical terminology. Familiarity with community services/resources. Ability to maintain effective working relationships with patients/families. Knowledge of current community resources. Strong assessment and crisis intervention. Strong collaborative

skills:

and a desire to work in a complex, fast-paced environment. Excellent interpersonal

skills:

Excellent collaboration, customer service and advocacy

skills:

Excellent written and verbal communication

skills:

Additional Job Details (if applicable) Working Model

Requirements:

M-F Eastern Business hours required Remote work requires stable, secure, compliant, quiet, work station, lockable drawer and Teams Video access requires via MGB provided equipment Meeting onsite optional. Must be able to share community based details and resources for local areas and surrounding areas (helping member locate resources in the area is key, local to MA, knowledge required) This fully remote position primarily serves enrollees enrolled in the One Care and Senior Care Options (SCO) programs, focusing on populations residing in Essex, Middlesex, Suffolk, Norfolk, Plymouth, Bristol, Dukes, and Nantucket counties.

Responsibilities:

and caseload may be adjusted in response to changes in enrollee enrollment trends. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $19.42 - $27.74/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: Mass General Brigham Health Plan Holding Company, 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. Combat disease. Hold a hand.

• Help people.

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