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Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health

The Customer Service Representative assists members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals.The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM – 5PM EST.This job descrip

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers, as well as other TPAs, and enables them to solve the problems facing today's healthcare with our flexible and cutting-edge third-party administration services. Transform the health pl

Job DescriptionAbout The Role The Vice President, Project Management Office will lead strategic planning, execution, and oversight of the company’s critical initiatives, ensuring alignment with business objectives. This role will manage the Project Management/Implementation group to deliver complex, cross-functional projects in a matrixed environment while maintaining consistency and quality in project management practices across the organization. Primary Responsibilities • Define and execute the strategic direction of project management in collaboration with company leadership., • Drive the successful delivery of multiple, high-impact projects, ensuring outcomes are met on time and within budget., • Ability to assess project value and impact, ensuring initiatives deliver measurable ROI and align with business objectives., • Engage with colleagues, clients, and stakeholders to assess project requirements and align with business strategy., • Provide oversight of cross-functional projects, managing risks, resolving issues, and escalating as needed., • Develop and enforce key performance metrics, milestones, documentation, reporting requirements, and budgets., • Track and analyze product, program, and process costs to optimize efficiency and resource allocation., • Lead and mentor a team of Directors and Project Managers, fostering collaboration and best practices., • Ensure compliance with industry regulations, legal requirements, and company policies., • Continuously evaluate and implement process improvements to enhance project planning, execution, and governance., • Provide technical guidance on scope definition, risk mitigation, resource planning, and project deliverables., • Communicate department, program, and project performance to senior leadership through reports and presentations., • Stay informed on emerging trends, technologies, and best practices in project management., • Ability to assess project value and impact, ensuring initiatives deliver measurable ROI and align with business objectives.Essential Qualifications, • Deep expertise in project management principles with a proven ability to build lasting client relationships., • Strong leadership in matrixed environments, leveraging influence, collaboration, and strategic thinking., • Track record of delivering complex, cross-functional initiatives on time and within budget., • Exceptional analytical, problem-solving, and process improvement skills to enhance efficiency and reduce costs., • Ability to implement best practices, drive continuous improvement, and measure performance effectively., • Strong financial acumen, including budgeting, forecasting, and resource management., • Excellent communication, negotiation, and stakeholder engagement skills., • Highly organized with keen attention to detail and ability to manage multiple priorities., • Proficiency in Microsoft Office Suite and other relevant project management tools., • Visionary leader with an innovative mindset, skilled in building high-performance teams.Education and Experience, • Bachelors degree in related field required; Masters degree preferred., • At least ten years of experience in project and program management in a healthplan., • Project Management Professional (PMP) or similar certification highly desired. At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™. Company Mission Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners. Company Vision Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. DEI Purpose Statement At BHPS, we encourage all team members to bring your authentic selves to work with all of your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level. Annual Salary Range: $150,000 - $230,000 The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity. *We are an Equal Opportunity Employer JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: Powered by JazzHR oH14RKdKLk

Job DescriptionAbout The Role The Customer Service Representative assists members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, and appeals. The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM – 5PM EST. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities and activities may change, or new ones may be assigned at any time with or without notice. Primary Responsibilities • Handle inbound calls from members, medical providers, and others., • Listen to and address customer needs and concerns empathetically., • Answer questions about, network participation, • Ensure first contact resolution when possible., • Update customer files and communicate effectively with teams., • Transfer misdirected requests and offer solutions to non-routine issues., • Contribute to customer satisfaction and business improvement., • Collaborate with other team members., • Adapt responses to caller understanding., • Educate callers and validate their understanding., • Support projects and other departments as directed by management.Essential Qualifications The successful candidate will have experience in a high-volume call center, experience with medical specialties, complaints and appeals and call center responsibilities. Previous experience in a physician’s office, group practice, clinic or hospital-based practices. • High School diploma with some college or business school education preferred., • Basic computer operations knowledge., • Intermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)., • Strong time management skills., • General knowledge of HIPAA Confidentiality laws., • Quick learner with ability to grasp managed care procedures., • Detail-oriented and dependable., • Effective listening and responding skills., • Flexible and adaptable to changes, with conceptual thinking., • Strong problem-solving abilities., • Excellent attendance and punctuality., • Comfortable performing tasks at a computer/telephone station. XCPc21oNJG