Jobs at Brighton Health Plan Solutions

Manage relationships and retention for a portfolio of workers’ compensation and auto insurance claims clients, including employers, TPAs, PPOs, bill review organizations, and carriers. Drive renewals, client satisfaction, new sales, service expansion, implementations, integrations, issue resolution, and strategic account growth. Collaborate with operations, network, analytics, finance, marketing, clinical, and vendor teams while providing insights and representing the company at client meetings and industry conferences. The role requires 20%+ travel.

The Account Executive manages client relationships, focusing on retention and satisfaction while coordinating internal teams to address client needs and deliver insights.

Support and maintain healthcare claims processing applications: gather requirements, design solutions, perform data transformations, program rate/builds and benefits, troubleshoot and resolve issues, collaborate with vendors and offshore teams, participate in upgrades and deployments, and validate work through QA.

The Contract Manager will oversee contracts with health systems, manage provider networks, conduct financial analyses, and negotiate agreements to ensure competitive arrangements.

Review high-dollar facility and physician/ancillary claims for accurate pricing, billing, DRG assignment and drug reimbursements; develop tracking reports; collaborate with CMO, Legal, vendors and other stakeholders.