Brighton Health Plan Solutions

We are a health care enablement company, founded in 2016. We transform health care access and delivery through customizable, sustainable solutions. Our solutions aim to encourage patient activation, improve care quality, and manage costs. We serve self-funded plan sponsors, health systems, and TPAs.

We leverage decades of experience in health plan design and management. Our offerings include proprietary provider networks (MagnaCare, Create®, and Casualty) and a white-labeled technology platform. This platform enhances the experience for providers, plan purchasers, and health care consumers. Our services specialize in health plan and health insurance for the Hospitals and Health Care industry.

We handle operational activities like enrollment and eligibility processing, managing eligibility files, addressing caregiver inquiries, and supporting client eligibility. We also handle medical necessity and benefit coverage determinations, provide clinical support, and manage case management programs. Working with Commercial and Worker’s Compensation self-funded clients, we focus on claims resolution, medical cost containment, and delivering quality healthcare.

We are a company of 201-500 employees. Our work environment emphasizes collaboration. Teams work across departments like finance and client teams, and with external partners, to resolve issues and support projects.

We expect employees to pay meticulous attention to detail, communicate strongly across phone, chat, and email, and have strong problem-solving abilities. We value process improvement and delivering high-quality service. Roles often require adaptability, including working alternative schedules for West Coast business hours.

Leadership roles involve overseeing departments like Clinical Services and Casualty. Leaders drive governance, monitor performance, and ensure continuous process improvement and regulatory compliance. We offer remote work options for various positions, with some roles providing flexibility to work remotely or on-site in New York or New Jersey.