Prepare, analyze, research, and adjust financial statements for management presentation. Creates relevant work papers, schedules, and reconciliations. Review and comprehend financial indicators and results of operations, significant operational statistics, variances from budget and historical results. Research technical accounting and financial reporting issues, and assis

Leadership and Transformation of Medicaid UM/CM Programs in support of One Sentara. Continuous improvement in Medicaid clinical performance including readmissions, chronic care utilization and unplanned care through CM outreach and programs. Adherence to each state's Medicaid contract UM/CM requirements. Coordination with Medicare UM/CM to ensure seamless care and managem

Support Sr. Sales Executives and/or Sr. Account Executives in producing and retaining profitable business within small and mid sized segments. Interact with general agents, brokers, benefit administrators, members, and internal resources as needed to achieve profitable growth objectives. HS grad and 5 years related experience. Related years of experience includes Administ

Cultivate and manage relationships with assigned brokers and territories to achieve profitable net new business objectives. Responsible for managing the entire sales process with assigned brokers and direct prospects or sales leads as assigned by Sales Manager. Bachelor's degree with 2 years of sales experience required, or HS Diploma and 5 years sales experience required

AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Sr. Underwriter in Miami and/or Gainesville, Florida. This is a hybrid position, 2 days in office and 3 days remote if within local market or 100% remote if outside of local territory. Scope of position The Sr. Underwriter reviews and analyzes risks posed by employer groups requesting group healt

The Medical Director is responsible for providing clinical leadership within Sentara Health Plans, aligned to one or more plans. Accountable for monitoring utilization, case management and quality outcomes. The Medical Director collaborates with the Sentara Health Plans Chief Medical Director, Senior Medical Director(s) and Clinical Care Services (CCS) teams to establish,

Assist in any and all of the functions normally associated with a qualified health actuary including IBNR calculation; the determination of rating factors such as age, sex, location, or industry; development of rates and filings for the BOI; suggestions for periodic group rating changes; development of necessary rates for government programs; assistance with the developme

Responsible for managing patient's medical nutrition therapy in accordance with the medical staff approved clinical practice standards for high risk patients. Serves as a resource for nutrition education. Board Certified Specialist in one of the recognized ADA/NATCO/NBNSC specialty certifications Cert Nutrition Support Clinician (CNSC), Renal Nutrition (CSR); Certified Sp

The Medicaid Plan President is Sentara's expert resource regarding the MLTSS beneficiaries. The Medicaid Plan President provides leadership and Medicaid long term services and supports expertise to Sentara Health Plans' clinical, provider network, marketing, operations and quality department staff as it relates to MLTSS. Ensures appropriate prioritization of initiatives a

Assist in any and all of the functions normally associated with a qualified health actuary including IBNR calculation; the determination of rating factors such as age, sex, location, or industry; development of rates and filings for the BOI; suggestions for periodic group rating changes; development of necessary rates for government programs; assistance with the developme

The Digital Media Specialist is responsible for the creation and implementation of all manner of content for the Sentara public website, sentara.com, and social/digital media presence in support of the Sentara strategic and marketing goals. Bachelors in business, marketing, public relations, communications, digital media, digital journalism, architecture, or related field

Cultivate and manage relationships with assigned brokers and territories to achieve profitable net new business objectives. Responsible for managing the entire sales process with assigned brokers and direct prospects or sales leads as assigned by Sales Manager. Bachelor's degree with 2 years of sales experience required, or HS Diploma and 5 years sales experience required

The primary role of the Provider Data Enrollment Specialist I is to ensure the data integrity of provider records entered and maintained in the credentialing and/or payment systems. This position may be responsible for all aspects of ensuring accurate and timely processing of provider setup to initiate credentialing, provider record updates and edits, processing provider

Responsible for all areas of customer service as it pertains to the acquisition and/ or retention of members for Sentara Health Plan, Inc. This includes functions associated with the administration of all group information processing of claims, interaction with members, providers and employers. Special reports and projects to include initial review and analysis, recommend

Professional individual who is experienced in high dollar contract negotiations. Independently run effective business meetings. Be able to independently reach out to vendors and customers to provide a high level of service and creative win win negotiating scenarios to benefit all parties. This person will need to analyze proposals effectively and provide summaries and rec