Sentara Health

Business Analyst

• Coordinate with other Encounters Department team members in the preparation, validation, and submission of adjudicated claims data (“Encounters”), to both state and federal agencies.
• Under general supervision, train and develop proficiencies in data analysis techniques relating to Encounters submission data received by the Health Plan from state and federal agencies.
• Work with Sr. Business Analysts to coordinate efforts to identify, analysis, and remediate identified errors via reprocessing.
• Over time, develop sufficient operational expertise (systems and tools, methodologies, contractual / technical requirements) to support the Encounters workstream actively and competently in all major operational areas (data requirements, data structure, submissions, and remediation).
• Establish and maintain working relationships with peers, key departmental stakeholders, and external servicing vendors relating to assigned Market(s) / Lines of Business (LOBs).
• Partner with Sr. Business Analysts and the Encounters Leadership Team in ongoing efforts to establish, maintain, and incorporate improvements to departmental documentation needs (task schedules, submissions tracking, Standard Operation Procedures (SOPs)).
• Assist Sr. Business Analysts and the Encounters Leadership Team in ongoing User Acceptance Testing (UAT) needs relating to internal systems upgrades, configuration changes, and new vendor / LOB implementations.

Business Analyst – Encounters

Director

• Responsible for planning, organizing and directing the operations of technology-based business functions of the health plan.
• Identifies, evaluates and quantifies the technology, information systems and business needs of the plan for the purpose of improving and/or integrating systems.
• Provides new systems/technology and/or business solutions.
• Monitors system enhancements and adoption to ensure continuous quality improvement and compliance.
• Leads mission critical, cross-functional initiatives from detailed business requirements development and budget approval through to successful completion.
• Applies lean practices across value stream to continually improve processes and outcomes.

Director, Business Testing

Manager

• Responsible for case management services within the scope of licensure
• Develops, monitors, evaluates, and revises the member's care plan to meet the member's needs
• Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs
• Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
• Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits
• Assists with the implementation of member care plans by facilitating authorizations/referrals
• Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
• Presents cases at case conferences for multidisciplinary focus
• Ensures compliance with regulatory, accrediting and company policies and procedures

Nurse Case Manager, Central Region – Community Visits

Full-stack Engineer

• Responsible for the administration, configuration, and ongoing support of the Jira project management platform
• Customizes Jira to meet business needs while ensuring system efficiency and security
• Works closely with cross-functional teams including project managers and software developers
• Manages Jira projects and workflows, controls user access, and supports integrations with other tools
• Performs routine maintenance and updates of Jira
• Provides training and support to end users
• Generates custom reports and dashboards to support visibility and decision-making.

Software Engineer – JIRA Admin

Analyst

• Lead the configuration and maintenance of Epic Healthy Planet tools, including Compass Rose, registries, care gaps, risk scores, and reporting dashboards
• Collaborate with clinical, operational, and technical teams to understand population health goals and translate them into Epic workflows
• Design and implement solutions that support care management, quality improvement, and risk stratification
• Serve as a subject matter expert for Healthy Planet and provide guidance on best practices and optimization opportunities
• Manage project timelines, deliverables, and stakeholder communications
• Conduct testing, validation, and troubleshooting of Epic functionality
• Provide training and support to end-users and analysts
• Stay current with Epic updates and industry trends in population health and value-based care

Senior IT Specialty Analyst

• Performing complex analysis and system configuration.
• Provide configuration support and project-related activities for internal and external customers, vendors, and consultants.
• Moderate level functional analysis to support management decisions.
• Detailed and technical system configuration.

Configuration Analyst

Medical Billing and Coding

• Responsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), or other third party payer specific claims processing guidelines
• Works with Coding, Billing and Reimbursement staff to resolve edits
• Responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing
• Researches regulations to ensure accuracy of CPT codes and documentation.

Claims Resolution Coder

• Incumbent will identify opportunities to leverage technologies in areas that improve and enhance 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 technological 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.

Senior Business System Analyst

Events

• Interview Day for Radiology
• Recruiter will reach out to schedule an interview
• Hiring for various Tech roles in Imaging modalities at multiple locations
• Involvement in imaging patient care

Imaging Technologist, All Modalities

Systems Engineer

• 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.

Senior Business Systems Analyst

QA Engineer

• Audit day to day processes SHP PSC staff and transportation provider and working collaboratively with SIU to escalate FWA cases
• Develop the audit tools
• Complete the audits to include JIVA authorizations and CM notes
• Listening to NIC live and recorded calls
• During training they will be expected to take live calls from member, manage the call queue, manage cases to include advising members their trips are either approved or denied!
• With expectation they will cover for PSC and Manager when out of the office.

Quality Assurance Coordinator – Transportation Team

• Provision of medical social work services to patients receiving care in the hospital setting.
• Assesses the social, psychological, cultural, environmental, and financial situations, as well as disposition needs of each referred patient.
• Collaborates with patients, families, healthcare team members, and community organizations.
• Uses strong advocacy skills to identify needs and resources in the hospital and community.
• Develop and evaluate effective transition plans taking into consideration the client's diagnosis, prognosis course of treatment, past and present services, short-term and long-term goals, and provider options.

MSW Case Manager, Resource Pool Inpatient Social Worker

• Supervise and manage a 24-hour operation
• Manage patient flow, employee work assignments, and resources
• Mentor and assist staff
• Interview, hire, and develop team members
• Engage in talent retention strategies for the area(s) of responsibility

Registered Nurse Manager – Emergency Department

• Upload your resume and interview with Sentara managers from all 12 of our hospitals.
• Interview for the chance to secure a possible job offer.
• Qualified new grads accepting an offer in Med surg units are eligible for an additional $4,500 sign on bonus.
• Talk with our team about opportunities across the Sentara system.