SH

Sentara Health

19 open positions available

3 locations
1 employment type
Actively hiring
Full-time

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Showing 19 most recent jobs
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Senior Software Engineer (Workday Integration) - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$80K - 134K a year

The Senior Software Engineer will develop multiple types of software, including end-user applications and enterprise data architecture. Responsibilities include understanding software functionality, writing code, supporting software testing and deployment, and applying best practices in software development. | Candidates should have at least 5 years of experience as a Workday Integration Developer and strong knowledge of EIBs, Workday Studio, and Cloud Connect. A Bachelor's degree or 4 years of related experience is required, with experience in production support being helpful. | City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara is hiring for a Workday Integration Developer! This position is fully remote! Overview Software product development focuses on developing multiple types/categories of software including end-user applications, enterprise data architecture, and operating systems/utility software and tools, which provides a platform for running end-user applications for external customers. The work includes: •Understanding the domain of the software problem and/or functionality, the interfaces between hardware and software, and the overall software characteristics •Using programming, scripting, and/or database languages to write the software code •Supporting software test engineering, DevOps, deployment, maintenance, and evolution activities by correcting programming errors, responding to scope changes, and coding software enhancements •Applying knowledge of software development best practices, including technical design specifications, coding standards, code reviews, source control management, build processes, testing, and operations. An Experienced Professional applies practical knowledge of job areas typically obtained through advanced education and work experience. Responsibilities typically include: • Works independently with general supervision. • Problems faced are difficult but typically not complex. • May influence others within the job area through explanation of facts, policies, and practices. Education Experience in lieu of a Bachelor's Degree Bachelor's Degree or 4 years of related experience. Certification/Licensure No specific certification or licensure requirements Experience At least 5 years Workday Integration Developer Experience Strong knowledge of EIBs, Workday Studio, Cloud connect and other APIs Demonstrated experience in developing new Workday integrations based on customer requirements Experience in using Service Now for incident management is nice to have but not required Experience in production support helpful. Monitoring and fixing failed integrations. We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $80,204.80 - $133,681.60. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Keywords: EIB, Workday Studio, Studio Integration, Cloud Connect, API, Workday integrations, Workday Integration Developer, Studio Integration, #Indeed, #LI-DS1 . We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$91,416.00-$152,380.80. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met Sentara Independence provides quality outpatient services to the surrounding community. The facility includes an ambulance-accessible emergency room that is supported by board-certified physicians. Sentara Independence houses state-of-the-art medical equipment and highly-skilled physicians and staff. Sentara Independence is now an extension of the quality services at Sentara Virginia Beach General Hospital including advanced imaging and physical therapy. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Workday Integration Developer
EIB
Workday Studio
Cloud Connect
API
Service Now
Production Support
Software Development
DevOps
Software Testing
Coding Standards
Source Control Management
Build Processes
Technical Design Specifications
Software Enhancements
Incident Management
Direct Apply
Posted 1 day ago
SH

Customer Service Rep I - Blue Ridge Region (Cardiology, Remote)

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

Responsible for handling incoming calls to effectively address issues related to member eligibility, plan prescription benefits, and claim payment issues. Also responsible for patient services needs such as updating billing information, establishing payment plans, and resolving payment inquiries. | A high school diploma is required, along with two years of customer service experience and previous data entry experience. Healthcare experience is strongly preferred. | City/State Harrisonburg, VA Work Shift First (Days) Overview: Customer Service Representative I Blue Ridge Cardiology Remote Responsible for all areas of customer service as it pertains to research and resolution of telephone inquiries from members or patients. Primarily responsible for handling incoming calls to effectively address issues related to either member eligibility, plan prescription benefits, and claim payment issues or patient services needs such as updating billing information, establishing payment plans, resolving payment inquiries, or patient scheduling. Responsible for all areas of customer service as it pertains to research and resolution of telephone inquiries from members or patients. Primarily responsible for handling incoming calls to effectively address issues related to either member eligibility, plan prescription benefits, and claim payment issues or patient services needs such as updating billing information, establishing payment plans, resolving payment inquiries, or patient scheduling. Provide quality service and customer satisfaction through effective communication and education. You must be within one hour of either Sentara Martha Jefferson Hospital or Sentara Rockingham Hospital Education High School Diploma Certification/Licensure No specific certification or licensure requirements Experience Two years Customer Service Exp Previous Data Entry Experience Health care experience strongly preferred Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Customer Service
Data Entry
Healthcare Experience
Communication
Problem Solving
Billing Information
Payment Plans
Claim Payment Issues
Patient Scheduling
Member Eligibility
Prescription Benefits
Research
Resolution
Education
Satisfaction
Inquiries
Direct Apply
Posted 1 day ago
SH

Associate Fraud and Abuse Investigator

Sentara HealthAnywhereFull-time
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Compensation$22.36 - 37.26 hour

The Associate Fraud and Abuse Investigator is responsible for contributing to in-depth investigations of suspected fraud or abuse across various interactions. This includes reviewing coding practices, assessing incoming referrals, and maintaining comprehensive case files. | A Bachelor's Degree is required, or a minimum of 2 years of combined experience in relevant fields such as Medical Coding or Healthcare. Certification as a Certified Professional Coder (CPC) is also required, with additional certifications preferred. | City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent position (40 hours) Work hours: 8am to 5pm EST, M-F Location: This position is remote for candidates that live in the following states: VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year. Job Responsibilities: Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products. Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits. Contribute to the review of reimbursement systems relating to health insurance claims processing and ensures adherence to policies and procedures for its various product offerings. Specific progression of responsibility is a follows dependent upon education, certifications, and experience: - Triage and prioritize leads/member complaints from internal sources. - Review and assess incoming referrals; Assist in the investigation of potential fraud, waste, and abuse. - Conduct research in support of an investigation. - Collect and evaluate potential suspicious patterns in claims data, provider enrollment data, and other sources and refers to Investigator for investigation or settlement. - Assures accurate reimbursement is obtained and coding practices are compliant. - Maintain comprehensive case files. - Participates in special projects as required. Education: Bachelor's Degree REQUIRED OR Minimum of 2 years combined experience required in Medical Coding OR Healthcare (Medical Chart Review/Insurance Billing) OR Internal/External Audit OR Regulatory/Compliance OR Claims Investigations OR Criminal Investigation/White Collar Crime REQUIRED Certifications/Licenses: Certified Professional Coder (CPC) REQUIRED (or achieved within 12 months of hire date) Certified Fraud Examiner (CFE) OR Accredited Health Care Fraud Investigator (AHFI) preferred. Experience: Job skills: Professional Writing, Verbal Communication, Time Management, Complex Problem Solving/Critical Thinking, Microsoft Excel and Word, Microsoft Access and Outlook Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $22.36 hour- $37.26/hour. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-77536 Talroo-Health Plan Keywords: Healthcare, Health Plan, Remote, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming, Bachelor's Degree, Medical Coding, Medical Chart Review, Insurance Billing, Internal/External Audit, Regulatory, Compliance, Claims Investigations, Criminal Investigation, White Collar Crime, Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), Accredited Health Care Fraud Investigator (AHFI), Federal Bureau of Investigation Training Program (FBITP) - Criminal Investigator Training Program (CITP); Certified Forensic Interviewer (CFI), Certified Fraud Specialist (CFS), Certified Professional Coder (CPC) or Certified in Healthcare Compliance (CHC), Fraud, Waste, Abuse, Program Integrity, FWA, PI, Professional Writing, Verbal Communication, Time Management, Complex Problem Solving/Critical Thinking, Microsoft Excel and Word, Microsoft Access and Outlook Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Professional Writing
Verbal Communication
Time Management
Complex Problem Solving
Critical Thinking
Microsoft Excel
Microsoft Word
Microsoft Access
Microsoft Outlook
Direct Apply
Posted 6 days ago
SH

Behavioral Health Patient Services Coordinator - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

This position will assist members in locating new providers and help link them with recommended services after service denials. Administrative tasks will also be assigned as needed. | A high school diploma is required, along with experience in healthcare, preferably in behavioral health. No specific certification or licensure is mentioned. | City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Patient Services Coordinator - Remote in Virginia Beach, VA! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: Hybrid position in Virginia Beach, VA. May include visits to members in the emergency department or IP hospital settings in the VA Beach area, and the rest of the time will be working from home. Overview This position will be responsible for assisting members with locating new providers if current providers move out of network, close or have to end services for some other reason. The position will also help call members who have received service denials and help link them with the recommended services by the doctor. They will also be responsible for administrative tasks as assigned. Education High School Diploma (Required) Certification/Licensure No specific certification or licensure requirements Experience Experience working in Healthcare Experience with behavioral health (preferred) Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-90928 #Indeed Talroo - Health Plan Keywords: Health Plan, Healthcare, MCO, Managed Care, Remote, Virginia Beach, behavioral health, utilization management, Patient services coordinator Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Healthcare
Behavioral Health
Patient Services
Administrative Tasks
Provider Network
Service Denials
Chronic Illness Support
Wellness Programs
Clinical Services
Community Involvement
Development Opportunities
Health Plan Coverage
Integrated Services
Family-Friendly Culture
Quality Improvement
Patient Safety
Direct Apply
Posted 7 days ago
SH

Senior Business System Analyst - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$NaNK - NaNK a year

Support, enhance, and implement software applications, manage projects, and liaise with stakeholders. | Bachelor's in a relevant field or 6+ years of experience, proficiency in SQL, HTML, CSS, and project management skills. | City/State Richmond, VA Work Shift First (Days) Overview: This position is responsible for support, enhancement and implementation software applications used within the organization. Oversees and directs intermediate scale projects or components of large-scale projects; develops project plans and timelines and coordination of project resources. Description Incumbent will identify opportunities to leverage technologies in areas that improve and enhance the business practices by designing and implementing application/product enhancements. Works with and is a liaison to customers and end-users, appropriate IT personnel and software vendors on a regular basis to align technology functionality to operational processes. Assess, research, analyze, and document stakeholder needs, selecting the appropriate information gathering and/or modeling technique to elicit requirements. Develop detailed test cases, execute them, and share results with business and tech managers for approval. Work jointly with developers to solution and provide cost and time estimates on fixes and enhancements. Performs longer term analysis and design of systems and hardware to maintain the production environments. Synthesize requirements and develop recommendations that best meet the objectives of the business. Works on project teams that are developing or modifying very complex information systems. Education Bachelor’s degree preferably in a field such as Computer Science, Business, Technical, Education, Information Systems, Finance, Business Administration, Accounting, Engineering, Information Technology (Required) or Candidates without a bachelor’s degree with 6 or more years of relevant experience may be considered. Experience: 4 years of relevant experience (Required) Proficiency in SQL, HTML, and CSS (Preferred) Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

SQL
HTML
CSS
Project Management
Software Development
Direct Apply
Posted 8 days ago
Sentara Health

Business Operations Analyst

Sentara HealthNorfolk, VAFull-time
View Job
Compensation$61K - 101K a year

Provide off-hours customer support, monitor inquiries, escalate issues, document interactions, collaborate with daytime staff, participate in on-call rotations, and report service trends. | 2+ years workforce management or call center operations experience, strong communication and problem-solving skills, familiarity with specific workforce management tools, and ability to work independently during off-hours. | City/State Norfolk, VA Work Shift Rotating Overview: Job Title: Business Operations Analyst – Evening, Weekend & Holiday Coverage (24x7 Support) Reports To: Director, Call Center Operations Location: Remote Position Type: Full-Time (Non-Standard Hours) Workforce Management experience required! 24x7 on call availability may be required. This is a remote position: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming We are seeking a dedicated and flexible Business Operations Analyst to provide critical off-hours support for a high priority 24x7 account. This role complements our existing daytime coverage and ensures seamless customer service during evenings, nights, and weekends. Key Responsibilities: • Provide responsive and professional customer support during non-business hours (evenings, nights, weekends, holidays). • Monitor and respond to incoming inquiries via phone, email, and chat. • Escalate urgent issues according to established protocols. • Document interactions and resolutions accurately. • Collaborate with daytime staff to ensure continuity of service and knowledge transfer. • Participate in on-call rotations as needed to maintain 24x7 coverage. • Identify and report recurring issues or trends to improve service delivery. Two Schedule are available: Schedule 1: • Shifts covering evenings, nights, weekends, and holidays. • Active Shift(s): • Weekday Evenings: Monday, Wednesday and Thursday, 4 PM – 12:30 AM • Schedules may rotate based on holiday schedule which will be included • Weekend Days: Saturday & Sunday, 9 AM – 5:30PM • On-call availability may be required for critical incidents. Schedule 2: • Shifts covering evenings, nights, weekends, and holidays. • Active Shift(s): • Monday and Tuesday 4:30 PM - 2AM; Friday 4 PM – 12:30 AM • Schedules may rotate based on holiday schedule which will be included • Weekend Days: Saturday & Sunday, 4:30 PM – 1:00AM • On-call availability may be required for critical incidents. Qualifications: • 2+ years of experience in workforce management or call center operations required. • Comfortable working independently during off-hours. • Strong communication and problem-solving skills. • Ability to manage multiple tasks and prioritize effectively. • Familiarity with NICE WFM (NICE IEX), Epic, CMS, ISSup, QGenda & Webstation. • Experience supporting high-touch or enterprise-level accounts is a plus. Preferred Traits: • Self-starter with a proactive mindset. • Calm under pressure and able to handle escalations professionally. • Tech-savvy and adaptable to new tools and systems. Education: • Bachelors preferred • HS Diploma required • Experience: • Three years of related experience is required in one of the following areas: Operations, IT or Reporting. • Must have strong workforce management experience required We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $29.21.04/HR – $48.68/HR. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Workforce Management
Call Center Operations
Customer Support
Communication
Problem Solving
NICE WFM
Epic
CMS
ISSup
QGenda
Webstation
Verified Source
Posted 11 days ago
Sentara Health

Operations Coordinator

Sentara HealthNewport News, VAFull-time
View Job
Compensation$40K - 55K a year

Perform administrative and clerical tasks including customer service, scheduling, report preparation, accounts payable, payroll, supply ordering, and technical support for department staff. | High school diploma or equivalent, 2 years clerical experience preferred, proficiency in Microsoft Office, and preferably office management and cardiology patient scheduling experience. | City/State Newport News, VA Work Shift First (Days) Overview: Sentara Medical Group is hiring an Operations Coordinator Work Location: Sentara Cardiology Newport News and Williamsburg, VA Work Schedule: Monday-Friday, 8:30-5:00 p.m., hours may vary Overview As an Operations Coordinator with Sentara, you will support the team and Leader. Performs administrative tasks to include providing customer service through phone and personal interactions. Responsible for correspondence, scheduling meetings, preparing departmental reports, statistics and file maintenance. Prepares and processes accounts payable, payroll, employee mileage reimbursement claims and operational information. Responsible for supply ordering and charge entry. Performs technical support and administrative support to department staff. Education • High School Grad or Equivalent Certification/Licensure • No specific certification or licensure requirements Experience • Clerical Experience 2 years • Microsoft Office Suite • Secretary 2 years preferred • Office Management 2 years preferred • Cardiology/Electrophysiology patient scheduling preferred Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day, join the Sentara Team! Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. keywords: clerical, administrative, office management, healthcare, cardiology, electrophysiology, patient scheduling, Monster Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Microsoft Office Suite
Clerical Experience
Administrative Support
Customer Service
Scheduling
Accounts Payable
Payroll Processing
Verified Source
Posted 11 days ago
Sentara Health

Lead IT Analyst - Community Connect - Remote (JR-84879)

Sentara HealthAnywhereFull-time
View Job
Compensation$91K - 152K a year

Lead and support Community Connect IT team by maintaining and enhancing Epic and third-party applications, managing upgrades, troubleshooting, workflow assessments, and leading projects. | 6-8 years of relevant experience with a degree or 8-10 years without, Epic Ambulatory certification, strong Excel and project skills, IT support proficiency, leadership experience, and ability to work remotely. | Sentara Health is an integrated, not-for-profit health care delivery system with over 130 years of dedicating to its mission of improving health every day. It is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country. Sentara employs 30,000 individuals, operates 12 hospitals in Virginia and Northeastern North Carolina, and serves over 1.2 million members through Sentara Health Plans in Virginia and Florida. The organization is nationally recognized for clinical quality, safety, and innovation, and has received accolades from IBM Watson Health and Forbes for its exceptional working environment. Role Description This is a full time fully remote position based in Virginia Beach, VA. As the Community Connect Lead IT Analyst, you will help support the day-to-day operations of the Community Connect team and projects. The ability to lead other analysts, multitask, and think ahead/outside of the box is crucial. This role reports to the Community Connect IT Manager and is responsible for maintaining and enhancing enterprise software applications, including Epic and third-party integrations. Key duties include: • Performing application builds, upgrades, and system optimizations. • Troubleshooting and resolving application issues with minimal disruption. • Evaluating software updates for business and clinical impact. • Conducting workflow assessments and aligning technology with operational needs. • Leading IT projects, mentoring analysts, and supporting process improvements. • Managing incidents, problems, and changes to ensure smooth application performance. • Ability to create strong collaboration with stakeholders and a take proactive approach to driving strategic IT initiatives. Qualifications • Epic Certification – Ambulatory (Required) plus recent build experience preferred • Experience with an Epic Community Connect program is a plus • Strong Microsoft Excel and/or Project experience is preferred • Proficiency in Information Technology and Technical Support • Strong analytical and troubleshooting abilities • Excellent communication skills • Relevant experience in leading IT projects and teams • Bachelor's degree in information technology, computer science, or related field • Excellent work ethic with ability to proficiently work remotely with minimal supervision Education • 6-8 years of relevant experience with a degree (Required) • or • 8-10 years of relevant experience without a degree (Required) Compensation We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $91,416 - $152,380.80. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” all Sentara locations are tobacco-free environments. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Non-Sentara applicants - if you believe you are qualified for this position, please apply at: External Posting URL https://sentara.wd1.myworkdayjobs.com/SCS/job/Virginia-Beach-VA/Lead-IT-Analyst---Community-Connect---Remote_JR-84879 Sentara applicants - please apply at: https://www.myworkday.com/sentara/d/inst/15$392530/9925$249570.htmld

Epic Ambulatory Certification
Epic Community Connect experience
Microsoft Excel
Project management
Technical support
Analytical and troubleshooting abilities
IT project leadership
Communication skills
Verified Source
Posted 2 months ago
SH

Senior Business System Analyst - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$70K - 100K a year

Support, enhance, and implement software applications while managing intermediate scale projects and coordinating project resources. | Bachelor's degree in a related field and 5+ years of relevant experience with no specific certification requirements. | City/State Richmond, VA Work Shift First (Days) Overview: Overview This position is responsible for support, enhancement and implementation software applications used within the organization. Oversees and directs intermediate scale projects or components of large-scale projects; develops project plans and timelines and coordination of project resources. Education Required to have a bachelor's degree in any of the following disciplines - Computer Science, Business, Technical, Education, Information Systems, Finance, Business/Administration, Accounting, Engineering, Information Technology. Certification/Licensure No specific certification or licensure requirements Experience Required to have 5+ years of related experience. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Project Management
Software Application Support
Project Planning
Resource Coordination
Intermediate Scale Project Oversight
Direct Apply
Posted 3 months ago
SH

Senior Specialty Software Engineer - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

The Senior Specialty Software Engineer will work on developing various types of software, including end-user applications and enterprise data architecture. Responsibilities include understanding software functionality, writing code, and supporting software testing and deployment activities. | Candidates should have 5 to 7 years of relevant experience, with a preference for those holding a bachelor's degree. Knowledge of software development best practices and the ability to work independently with general supervision are essential. | City/State Harrisonburg, VA Work Shift First (Days) Overview: Overview Software product development focuses on developing multiple types/categories of software including end-user applications, enterprise data architecture, and operating systems/utility software and tools, which provides a platform for running end-user applications for external customers. The work includes: •Understanding the domain of the software problem and/or functionality, the interfaces between hardware and software, and the overall software characteristics •Using programming, scripting, and/or database languages to write the software code •Supporting software test engineering, DevOps, deployment, maintenance, and evolution activities by correcting programming errors, responding to scope changes, and coding software enhancements •Applying knowledge of software development best practices, including technical design specifications, coding standards, code reviews, source control management, build processes, testing, and operations. An Experienced Professional applies practical knowledge of job areas typically obtained through advanced education and work experience. Responsibilities typically include: • Works independently with general supervision. • Problems faced are difficult but typically not complex. • May influence others within the job area through explanation of facts, policies, and practices. Education Experience in lieu of Bachelor’s Degree 5+ years of relevant experience with a degree 7+ years of relevant experience without a degree Certification/Licensure No specific certification or licensure requirements Experience 5 to 7 years of relevant experience. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Software Development
Programming
Scripting
Database Languages
Software Test Engineering
DevOps
Deployment
Maintenance
Coding Standards
Code Reviews
Source Control Management
Build Processes
Testing
Operations
Technical Design Specifications
Direct Apply
Posted 3 months ago
SH

Specialty Software Engineer - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

The role involves developing various types of software, including end-user applications and enterprise data architecture. Responsibilities include understanding software functionality, writing code, and supporting software testing and deployment activities. | Candidates should have 3 to 5 years of relevant experience, with a preference for those holding a degree. Experience in software development best practices and various programming languages is essential. | City/State Virginia Beach, VA Work Shift First (Days) Overview: Overview Software product development focuses on developing multiple types/categories of software including end-user applications, enterprise data architecture, and operating systems/utility software and tools, which provides a platform for running end-user applications for external customers. The work includes: •Understanding the domain of the software problem and/or functionality, the interfaces between hardware and software, and the overall software characteristics •Using programming, scripting, and/or database languages to write the software code •Supporting software test engineering, DevOps, deployment, maintenance, and evolution activities by correcting programming errors, responding to scope changes, and coding software enhancements •Applying knowledge of software development best practices, including technical design specifications, coding standards, code reviews, source control management, build processes, testing, and operations. Education Experience in lieu of a Bachelor’s Degree 3+ years of relevant experience with a degree 5+ years of relevant experience without a degree Certification/Licensure No specific certification or licensure requirements Experience Required to 3 to 5 years of relevant experience Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Software Development
Programming
Scripting
Database Languages
Software Testing
DevOps
Deployment
Maintenance
Technical Design Specifications
Coding Standards
Code Reviews
Source Control Management
Build Processes
Operations
Software Enhancements
Programming Errors
Scope Changes
Direct Apply
Posted 3 months ago
SH

Care Coordinator

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

The Care Coordinator performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. They assist adult patients and their families with personal and environmental difficulties associated with medical conditions, including terminal illnesses. | Candidates must possess a degree in Health & Human Services or a related field, with at least one year of experience in Long Term Care, Health Plan, and Medicaid. Mental health experience is preferred. | City/State Fairfax, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Care Coordinator in Falls Church, Arlington, Woodbridge, Fairfax, VA and surrounding areas! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F The position requires both in person/face-to-face assessments and remote telephonic assessments for the LTSS Waiver population in Falls Church, Fairfax, Arlington, Woodbridge, VA and surrounding areas! Location: Candidate must reside in Falls Church, Fairfax, Arlington, Woodbridge, VA and surrounding areas! Job responsibilities: Performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. Must develop, participate and monitor multidisciplinary collaboration of services to patients where appropriate. Assist adult patients and their families with personal and environmental difficulties associated with medical condition up to and including at time of terminal illnesses. Education: Must possess a degree in Health & Human Services or one of the following related Fields: -Art Therapy -Behavioral Sciences -Child Development -Cognitive Sciences -Community Mental Health Counseling (MH, Vocational, Pastoral, etc.) -Counselor Education -Early Childhood Development -Educational Psychology -Gerontology -Healthcare Administration -Human Development -Human Services -Marriage and Family Therapy -Music Therapy -Nursing -Pharmacy -Psychiatric Rehabilitation -Psychology -Rehabilitation Counseling -Social Work -Sociology -Special Education -Speech Therapy -Therapeutic Recreation -Vocational Rehabilitation All degrees must be from schools that are listed as accredited on the U.S. Department of Education College Accreditation database found on the U.S. Department of Education website. Schools that are not listed on the database do not meet the standard as accredited. Degrees that have been obtained from schools outside the United States will be reviewed individually. Certification/Licensure None required Experience Long Term Care- 1 year; Health Plan- 1 year; Medicaid- 1 year REQUIRED At least one year of mental health experience preferred Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-85678 Talroo – Health Plan Keywords: Care Coordination, Human Services, Community Health, Health Education, Long Term Care, Health Plan, Social Work, Therapy, Counseling, Psychology, Waiver, LTSS, Medicaid, Managed Care, MCO, Alexandria, Falls Church, Arlington, Annandale, Woodbridge, Fairfax, VA, Virginia Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Care Coordination
Human Services
Community Health
Health Education
Long Term Care
Health Plan
Social Work
Therapy
Counseling
Psychology
Waiver
LTSS
Medicaid
Managed Care
MCO
Direct Apply
Posted 3 months ago
SH

Program Manager Compliance - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$106K - 177K a year

Oversee and coordinate multiple inter-related technical projects within the PMO to ensure alignment with business objectives and successful execution. | Minimum 3 years IT program/project management experience with a degree or 5 years without, strong governance and project delivery skills. | City/State Virginia Beach, VA Work Shift First (Days) Overview: Overview The IT Program Manager is responsible for overseeing and coordinating multiple inter-related technical projects within the Technical Program Management Office (PMO). This role ensures that projects align with business objectives, meet strategic goals, and adhere to best practices in program and project management. The IT Program Manager provides centralized expertise, governance, and support, driving efficiency and ensuring successful project execution. The IT Program Manager is responsible for overseeing and coordinating multiple inter-related technical projects within the Technical Program Management Office (PMO). This role ensures that projects align with business objectives, meet strategic goals, and adhere to best practices in program and project management. The IT Program Manager provides centralized expertise, governance, and support, driving efficiency and ensuring successful project execution. Education Bachelor's Degree (Preferred) Certification/Licensure No specific certification or licensure requirements Experience Required to have a minimum of 3 years of relevant experience in IT program/project management with a degree Required to have 5 years of related experience without a degree We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $106,080 - $176820.80. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Program Management
Project Management
Cross-Functional Collaboration
Stakeholder Communication
Process Improvement
Risk Mitigation
Workflow Automation
Strategic Planning
Direct Apply
Posted 3 months ago
SH

Care Coordinator

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

The Care Coordinator performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. They assist adult patients and their families with personal and environmental difficulties associated with medical conditions, including terminal illnesses. | Candidates must possess a degree in Health & Human Services or a related field and have at least one year of experience in Long Term Care, Health Plan, and Medicaid. Mental health experience is preferred. | City/State Winchester, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Care Coordinator in Winchester, VA and surrounding areas! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F The position requires both in person/face-to-face assessments and remote telephonic assessments for the LTSS Waiver population in Winchester, VA and surrounding areas! Location: Candidate must reside in Winchester, VA and surrounding areas! Job responsibilities: Performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. Must develop, participate and monitor multidisciplinary collaboration of services to patients where appropriate. Assist adult patients and their families with personal and environmental difficulties associated with medical condition up to and including at time of terminal illnesses. Education: Must possess a degree in Health & Human Services or one of the following related Fields: -Art Therapy -Behavioral Sciences -Child Development -Cognitive Sciences -Community Mental Health Counseling (MH, Vocational, Pastoral, etc.) -Counselor Education -Early Childhood Development -Educational Psychology -Gerontology -Healthcare Administration -Human Development -Human Services -Marriage and Family Therapy -Music Therapy -Nursing -Pharmacy -Psychiatric Rehabilitation -Psychology -Rehabilitation Counseling -Social Work -Sociology -Special Education -Speech Therapy -Therapeutic Recreation -Vocational Rehabilitation All degrees must be from schools that are listed as accredited on the U.S. Department of Education College Accreditation database found on the U.S. Department of Education website. Schools that are not listed on the database do not meet the standard as accredited. Degrees that have been obtained from schools outside the United States will be reviewed individually. Certification/Licensure None required Experience Long Term Care- 1 year; Health Plan- 1 year; Medicaid- 1 year REQUIRED At least one year of mental health experience preferred Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-86229 Talroo – Health Plan Keywords: Care Coordination, Human Services, Community Health, Health Education, Long Term Care, Health Plan, Social Work, Therapy, Counseling, Psychology, Waiver, LTSS, Medicaid, Managed Care, MCO, Winchester, VA, Virginia Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Care Coordination
Human Services
Community Health
Health Education
Long Term Care
Health Plan
Social Work
Therapy
Counseling
Psychology
Waiver
LTSS
Medicaid
Managed Care
MCO
Direct Apply
Posted 3 months ago
SH

Implementation Manager, Benefit Configuration

Sentara HealthAnywhereFull-time
View Job
Compensation$70K - 100K a year

Manage system benefit development and implementation, contract administration, compliance auditing, and process improvements to increase operational effectiveness. | Bachelor's degree with 3+ years of health insurance and healthcare industry experience. | City/State Richmond, VA Work Shift First (Days) Overview: Overview The Ops Support/Systems Administration manager manages all activities involving system benefit development and implementation, contract administration, coding compliance, fee schedule implementation, provider network database management and quality assurance, internal and external auditing of the key processes, system compliance and acceptance testing, and process improvements designed to increase operational effectiveness. Education Bachelor's Degree (Required) Certification/Licensure No specific certification or licensure requirements Experience Required to have three years of experience in the health insurance industry. Required to have three years of healthcare experience. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

System Benefit Development
Contract Administration
Coding Compliance
Fee Schedule Implementation
Provider Network Database Management
Quality Assurance
Internal and External Auditing
System Compliance and Acceptance Testing
Process Improvement
Direct Apply
Posted 3 months ago
SH

Senior Identity Access Management Engineer - Remote

Sentara HealthAnywhereFull-time
View Job
Compensation$91K - 152K a year

Manage on-premises Active Directory and Azure services, including administration, support, maintenance, and monitoring. Handle migration activities and day-to-day administration of escalated calls. | Candidates must have 7+ years of experience managing Active Directory and related services, with specific experience in migrations and setting up conditional access policies. A degree is preferred, but extensive experience may substitute for formal education. | City/State Virginia Beach, VA Work Shift First (Days) Overview: Overview Manage on-premises Active Directory, Entra ID (Azure Active Directory), AD Federation Services (ADFS), and Azure AD Connect servers. Administration, support, maintenance, and monitoring Manage conditional access policies, application integrations, and Identity synchronization from on-premises AD to Entra ID. Day-to-day administration of L3 and escalated calls, and provide resolution. Handle migration activities in Active Directory, ADFS, Entra ID and Azure AD Connect. Be part of on-call rotation schedule Education Experience in lieu of a Bachelor’s Degree 5+ years of relevant experience with a degree (Required) 7+ years of relevant experience without a degree (Required) Certification/Licensure No specific certification or licensure requirements Experience Required to have 7+ years of experience in managing on-premises Active Directory, Entra ID (Azure Active Directory), AD Federation Services (ADFS), and Azure AD Connect servers. Required to have experience in migrations from AD/ADFS to Entra ID. Required to have experience in setting up conditional access policies, application integrations, PHS, and WS-FED Required to have knowledge of Industry standard authentication protocols – SAML, OpenID Connect, OAuth, and password less authentication. Candidate should be capable of driving projects, e.g. modernize the Active Directory environment, consolidate domains, and leverage cloud-based identity services. Good understanding of domain controller backup/restore/disaster recovery. Good understanding of AD security, attacks, and mitigations. . We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$91,416.00-$152,380.80. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met Sentara Independence provides quality outpatient services to the surrounding community. The facility includes an ambulance-accessible emergency room that is supported by board-certified physicians. Sentara Independence houses state-of-the-art medical equipment and highly-skilled physicians and staff. Sentara Independence is now an extension of the quality services at Sentara Virginia Beach General Hospital including advanced imaging and physical therapy. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Active Directory
Entra ID
Azure Active Directory
AD Federation Services
Azure AD Connect
Conditional Access Policies
Application Integrations
Identity Synchronization
Migrations
Authentication Protocols
Domain Controller Backup
AD Security
Disaster Recovery
Project Management
Cloud-Based Identity Services
Direct Apply
Posted 4 months ago
SH

Senior Benefit Configuration Analyst QNXT - Remote

Sentara HealthAnywhereFull-time
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Compensation$70K - 116K a year

The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform. This role ensures benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements. | Candidates must have 7+ years of hands-on QNXT benefit configuration experience and strong knowledge of QNXT system architecture. Proficiency in Microsoft SQL Server and understanding of regulatory requirements across various plans is also required. | City/State Richmond, VA Work Shift Multiple shifts available Overview: Overview The Senior Benefit Configuration Analyst is responsible for the analysis, design, build, and validation of complex benefit configurations within the QNXT platform to support accurate claims adjudication and compliance. This role works closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements. The senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance. Education Bachelor’s Degree (Required) Certification/Licensure No specific certification or licensure requirements Experience Required to have 7+ years of hands-on QNXT benefit configuration experience, preferably in a managed care or health plan environment. Required to have strong working knowledge of QNXT system architecture, including configuration tables, benefit logic, and claims integration. Required to have proficiency in Microsoft SQL Server (T-SQL) for data validation and troubleshooting. Required to have experience with CMT and QCS tools for version management, configuration migrations, and build monitoring. Required to have strong understanding of regulatory requirements across Medicare, Medicaid, ACA, and Commercial plans. Required to have excellent analytical, organizational, and problem-solving skills, strong written and verbal communication including technical documentation. Excellent interpersonal skills and team oriented. Preferred Qualifications Familiarity with implementation methodologies for new products or market launches. Knowledge of healthcare claims lifecycle, pricing, and accumulators. Lean Six Sigma or process improvement background is a plus. We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is: $ 69,867.20 - $ 116,438.40. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Keywords: QNXT, Benefit Configuration, SQL Server, CMT, QCS tools, Medicare, Medicaid, ACA, Commercial plans, lean six sigma, LSS, process improvement, QNXT system architecture, QNXT benefit configuration Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

QNXT
Benefit Configuration
SQL Server
CMT
QCS Tools
Medicare
Medicaid
ACA
Commercial Plans
Lean Six Sigma
Process Improvement
QNXT System Architecture
QNXT Benefit Configuration
Analytical Skills
Organizational Skills
Problem-Solving Skills
Communication Skills
Direct Apply
Posted 4 months ago
SH

ARTS Care Coordinator - Remote

Sentara HealthAnywhereFull-time
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Compensation$Not specified

The ARTS Care Coordinator reviews clinical information from providers to ensure it meets Medical Necessity Criteria for service authorization. This role requires knowledge of various healthcare protocols and ensures accurate data entry into the claims system for payment processing. | Candidates must have a Master's degree in Counseling, Social Work, or a BSN, along with relevant licensure. Additionally, two years of experience in behavioral health and one year in care coordination or related fields is required. | City/State Roanoke, VA Work Shift First (Days) Overview: Sentara Health is currently seeking a full-time remote Arts Care Coordinator. Position Status: Full-time, Day Shift Position Location: Remote in the state of Virginia Standard Working Hours: Monday - Friday, 8:00AM - 5:00PM EST. Overview The ARTS Care Coordinator is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, BH and ARTS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment Education Master's degree in Counseling or Social Work or BSN Certification/Licensure LCSW or LPC or LMFT or RN current license for the state of Virginia. LMHP- S, LMHP-R may be considered if actively working towards licensure and prior experience is present. Experience 2 years experience working in behavioral health and 1 years' experience with behavioral health care coordination, discharge planning, continuity of care or transitions of care required. Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Clinical Review
Managed Care Contracting
Medical Necessity
CMHRS Services
BH Services
DMAS Protocols
Regulatory Compliance
Behavioral Health Care Coordination
Discharge Planning
Continuity of Care
Transitions of Care
Direct Apply
Posted 5 months ago
SH

LTSS Waiver Authorization Coordinator- Remote in VA

Sentara HealthAnywhereFull-time
View Job
Compensation$Not specified

The LTSS Waiver Authorization Coordinator provides operational support for MLTSS clinical processes, collaborating with Care Coordination and LTSS Authorization teams. Responsibilities include reviewing reports, obtaining screenings, determining member eligibility, and submitting waivers to DMAS. | Candidates should have a minimum of 2 years of related experience in a medical setting, preferably in long-term care or Medicaid. An Associate's Level Degree is preferred, along with knowledge of Medicaid waiver services and experience with vulnerable populations. | City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is recruiting a Long-Term Services and Supports (LTSS) Waiver Authorization Coordinator! Status: Full-Time, permanent position (40 hours) Standard working hours: 8 am to 5 pm EST, M-F Location: This position can work remotely in VA. Job responsibilities: Responsible for providing operational support of MLTSS clinical processes in collaboration with the Care Coordination team and the LTSS Authorization team. Reviews reports, requests and documentation for information concerning LOC changes. Contacts authorized screening entities statewide to obtain MLTSS screenings within expected timeframes. Corresponds with DMAS to request screenings and to obtain regulatory guidance on the screening process and other processes that affect waiver eligibility. Corresponds with Nursing/Hospice Facilities for LOC change information, member data updates and regulatory reporting. Collaborates with LTSS Authorization team for members with CCC Plus waiver authorization requests. Reviews MLTSS screenings for validity and authorization. Determines member eligibility for LTSS waivers and completes charting. Submits waivers to DMAS for eligible members. Notifies Analytics Department for follow-up to ensure accurate payment from DMAS. Assists with corrections of LOC change forms and LOCERI assignments, and acts as a point of contact for access to DMAS portal. Reviews, approves, processes and audits charts for DMAS 225s. Provides education to Care Coordinators. Handles the fax queue; attaches faxes in the charting system and creates notifications. Other duties as assigned. Education: ALD - Associate's Level Degree preferred Certification/Licensure: None required Experience: Minimum of 2 years related working experience in a medical setting, preferably long-term care, home health, or MCO Medicaid experience Knowledge of Medicaid waiver services Experience working with low-income, disadvantaged, disabled, elderly, and vulnerable populations preferred. Preferred qualifications: ALD - Associate's Level Degree preferred Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health. Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-84102 #Indeed Monster Talroo – Health Plan LTSS Waiver Authorization Coordinator, MLTSS, Medicaid, MCO, Health Plan, DMAS, Remote, Virginia, VA, Long term care, home health Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

MLTSS
Medicaid
MCO
Health Plan
DMAS
Long Term Care
Home Health
Care Coordination
Regulatory Reporting
Eligibility Determination
Charting
Education
Operational Support
Collaboration
Data Updates
Screening Process
Direct Apply
Posted 5 months ago

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