Brighton Health Plan Solutions

Customer Service Representative

Experience in high-volume call center; claims inquiry/review; HIPAA knowledge; MS Office; strong communication and problem-solving skills.

Medical Director, Oncology

Board-certified medical oncologist/hematology-oncology or radiation oncology with 3+ years oncology practice and managed care experience; active US licensure; strong NCCN/ASCO/ASTRO guidelines knowledge; oncology utilization review and case management skills.

Medical Director

Board-certified physician with internal medicine or pediatrics; 3+ years in managed care/utilization management; unrestricted license; knowledge of evidence-based guidelines; strong communication.

Vice President, Enrollment and Eligibility

10+ years in health insurance; 5+ years of management; Bachelor's in Business or Health Insurance field.

Brighton Health Plan Solutions, LLC

Clinical Appeal Nurse

RN or LPN license; 5+ years in clinical appeals/grievances; 5+ years clinical experience across care settings; UM/Appeals knowledge; strong communication; MS Office; independent worker; adaptable; TPA experience preferred; coding certification preferred.

Manager, Provider Compliance

Lead No Surprises Act provider compliance; oversee disputes, QPA, IDR, and provider contracts; analytics and reporting; oversee claims processing and negotiations.

Board-certified physician with 3+ years in managed care/utilization management; licensed MD/DO; strong knowledge of evidence-based guidelines; excellent communication; able to lead and support case management teams.

Workers Compensation Nurse Case Manager

Nurse Case Manager

Licensed RN in NY or ability to obtain; CCM encouraged; 1 year WC case management experience; 4+ years clinical experience; Bachelor’s preferred; strong assessment, documentation, and customer service skills; proficient with MS Office.

Senior Accountant

Accountant

Bachelor's in accounting or finance; 3-5 years accounting experience; Excel (VLOOKUP, INDEX/MATCH, SUMIFS); Microsoft Dynamics AX; strong communication and detail orientation.

Enrollment and Eligibility Manager

Bachelor's degree or 8+ years of related experience; 6+ years in health plan management; 3+ years in management; strong leadership, analytics, and communication skills.

Implementation/ Engagement Manager

Implementation/Engagement Manager

7+ years in benefits administration/TPA operations or healthcare tech; proven cross-functional leadership; data conversion experience; strong client-facing skills.

Clinical Coordinator

High school diploma; strong medical records review; excellent customer service and communication; data entry; proficient with Word/Excel; detail-oriented; able to work independently; flexible hours.

Utilization Management Nurse

Licensed Practical Nurse (LPN) with active NC license; proficient with Microsoft Office; independent; strong organizational skills; UM experience; 2+ years in UM; 3+ years in clinical nursing preferred.

Account Executive

5+ years in account management/ client success in health plan/TPA; bachelor's degree; strong communication and relationship skills; Salesforce proficiency.

Title	Location	Date
Customer Service Representative Full Time · $41K-$48K · 0+ YOE New York, New York, United States · Onsite	New York, New York, United States Onsite	May 1, 2026
Medical Director, Oncology Part Time · 3+ YOE New Jersey, United States · Hybrid	New Jersey, United States Hybrid	Apr 30, 2026
Medical Director Full Time · $200K-$235K · 3+ YOE Westbury, New York, United States · Onsite	Westbury, New York, United States Onsite	Apr 21, 2026
Vice President, Enrollment and Eligibility Full Time · 10+ YOE Chapel Hill, North Carolina, United States · Onsite	Chapel Hill, North Carolina, United States Onsite	Apr 21, 2026
Clinical Appeal Nurse Full Time · 5+ YOE Chapel Hill, North Carolina, United States · Remote	Chapel Hill, North Carolina, United States Remote	Apr 21, 2026
Manager, Provider Compliance Full Time · 3+ YOE Chapel Hill, North Carolina, United States · Remote	Chapel Hill, North Carolina, United States Remote	Apr 15, 2026
Medical Director Part Time · 3+ YOE Chapel Hill, North Carolina, United States · Hybrid	Chapel Hill, North Carolina, United States Hybrid	Apr 13, 2026
Workers Compensation Nurse Case Manager Full Time · 1+ YOE Chapel Hill, North Carolina, United States · Onsite	Chapel Hill, North Carolina, United States Onsite	Apr 13, 2026
Senior Accountant Full Time · 3+ YOE Chapel Hill, North Carolina, United States · Hybrid	Chapel Hill, North Carolina, United States Hybrid	Apr 8, 2026
Enrollment and Eligibility Manager Full Time · 6+ YOE Chapel Hill, North Carolina, United States · Remote	Chapel Hill, North Carolina, United States Remote	Apr 2, 2026
Implementation/ Engagement Manager Full Time · 7+ YOE Chapel Hill, North Carolina, United States · Onsite	Chapel Hill, North Carolina, United States Onsite	Mar 27, 2026
Clinical Coordinator Full Time · 2+ YOE Chapel Hill, North Carolina, United States · Onsite	Chapel Hill, North Carolina, United States Onsite	Mar 18, 2026
Utilization Management Nurse Full Time · 2+ YOE Chapel Hill, North Carolina, United States · Remote	Chapel Hill, North Carolina, United States Remote	Mar 12, 2026
Account Executive Full Time · 5+ YOE Chapel Hill, North Carolina, United States · Hybrid	Chapel Hill, North Carolina, United States Hybrid	Feb 9, 2026

Activities	Third-party administration servicesHealthcare network administrationDirect provider contractingHealth plan managementHealthcare technology solutions
Headquarters	US
Industries	Managed CareHealthcare Technology
Name	Brighton Health Plan Solutions
Employees	600
Type	Private
Parent Company	Brighton Health Group
Subsidiaries	MagnaCareCreateBrighton Casualty Solutions
Tagline	Provides third-party administration and healthcare enablement services.
Founded	2,016
Website	brightonhps.com
Latest Funding Round	Corporate Round
Latest Funding Year	2,016
Latest Investors	Goldman SachsPamplona Capital Management

Brighton Health Plan Solutions

About Brighton Health Plan Solutions