New

Provider Network Quality Coordinator

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Jan 10, 2026
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. Responsible for supporting the provider data quality improvement and compliance initiatives by providing operational assistance. This role involves coordinating quality activities, maintaining accurate records, preparing reports, and facilitating communication across departments, ensuring the organization meets regulatory standards and continuously improves provider data quality. Essential Functions -Collects, organizes, and maintains data related to provider data measures, audits, and performance metrics. Assists in data analysis and interpretation, providing administrative support for quality improvement projects. -Monitors compliance with regulatory standards and reports any discrepancies or areas of concern to the Provider Network Growth team. -Contact healthcare providers and facilities listed in the provider directory via phone outreach. -Validate key provider information, including: practice name and address, phone number, office hours, whether the provider is accepting new patients, languages spoken, and network participation -Document and report findings using internal data collection tools or templates. -Identify and flag discrepancies or potential directory errors. -Follow standardized scripts and procedures to ensure consistency and regulatory compliance. -Work with internal teams (e.g., provider relations, compliance) to report trends or escalate issues. -Maintain a high level of professionalism and neutrality during all interactions. -Meet established call quotas and documentation deadlines. Education High School Diploma or Equivalent required Associate's Degree or Bachelor's Degree preferred Experience At least 1-2 years of experience in an administrative or support role, preferably within a healthcare setting required At least 1-2 years of experience in quality control, assurance, accreditation or other related role preferred Knowledge, Skills, and Abilities Familiarity with healthcare quality measures, regulatory requirements, and accreditation standards is a plus. Strong organizational, communication, and interpersonal skills. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and data management software. Ability to handle multiple tasks simultaneously and work effectively in a fast-paced environment. Working Conditions While a mostly remote role, you would attend team meetings every quarter at the office in Assembly Row, Somerville Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.