Sentara Health

Nurse

• Care for patients on telemetry monitoring
• Determine next steps needed in patient care, including cardiac cath, transfer for surgery or diagnostic tests
• Work in a 24-bed Medical/Surgical Cardiac Unit

Travel Registered Nurse, Medical/Surgical

Scrum Master

• Coordinate and monitor the scrum process from initiation through delivery.
• Serve as liaison between the product owner, development team, and management in order to ensure that all targets and requirements are met.
• Ensure that team members understand project objectives.
• Maintain product backlog and release plan and facilitate productivity by setting up meetings and removing impediments that may obstruct the pursuit of the team's sprint goals.
• Preserve flexibility and ability to rapidly respond to changes.

Senior Scrum Master

Business Analyst

• Responsible for the implementation and support of quality initiatives within assigned areas.
• Provides subject matter expertise related to quality initiative implementation, reporting, and analysis.
• Acts as a liaison between internal/external customers and Information Technology for business definition, scope, testing, and implementation to ensure quality, efficiency, effectiveness, and customer knowledge to improve business practices.

Senior Business Analyst

• 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
• 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

Senior Business System Analyst

Systems Engineer

• Identify opportunities to leverage technologies in areas that improve and enhance business practices by designing and implementing application/product enhancements.
• Work 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.
• Perform 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.
• Work on project teams that are developing or modifying very complex information systems.

Senior Business Systems Analyst

Clinician

• Review clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed
• Requires knowledge of medical necessity criteria for behavioral health and substance use 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.

Behavioral Health Utilization Management Clinician, LCSW, LPC, LMFT, RN

Social Worker

• Social Worker works in a collaborative role with all members of the health care team and community service agencies to coordinate care for Sentara Health Plan members to improve health outcomes.
• Assesses for barriers to compliance with the medical care plan and implements appropriate interventions to promote improved health and compliance with recommended therapy.
• Acts as a resource to assist members in need of community-based program assistance and empowers the member with the skills to navigate the process for obtaining appropriate medical care and community assistance.

Social Worker – Masters in Social Work (MSW) for Maternity/OBGYN

• Responsible for the day-to-day support, maintenance, and optimization of software applications that support Health & Wellness operations
• Partners with business and technical stakeholders to analyze requirements, troubleshoot application issues, and implement system enhancements that improve efficiency and user experience
• Application support, file mapping and data integration activities, SQL-based research and analysis, testing software upgrades and patches, and managing incidents, changes, and service requests
• Works closely with cross-functional teams, leveraging tools such as Jira to track work and support project initiatives

IT Systems Analyst

• 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
• Conducts gap in care management for quality programs
• Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements
• Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
• Presents cases at case conferences for multidisciplinary focus
• Ensure compliance with regulatory, accrediting and company policies and procedures
• May assist in problem-solving with provider, claims or service issues

Integrated Case Manager, RN

Data Analyst

• Transform population health data into meaningful stories: Create dashboards, scorecards, and reports that communicate trends, performance, and opportunities in a clear and actionable way.
• Develop analytics that drive enterprise-wide performance in the following domains: Quality Measures: HEDIS reporting, STAR ratings, gap closure
• Medical Expense: cost-of-care trends, utilization, savings opportunities
• Value-Based Care & Network Performance: contracting insights, pay-for-performance metrics, financial performance
• Employer Group Reporting: clinical and financial outcomes reporting for employer clients
• Clinical Integrated Network (CIN) Reporting: quality, financial, and operational analytics for CIN providers
• Provider Performance Analytics: quality, and financial performance analytics
• Benchmarking: quality, utilization, and performance benchmarking
• General Population Health Reporting: trends, cohorts, risk indicators, and care management support
• Support key reporting needs across the organization
• Engage directly with stakeholders: Collaborate with diverse internal teams, and external provider partners to understand analytic needs and translate them into actionable solutions.

Senior Healthcare Data Analyst

• Responsible for the implementation and support of quality initiatives within assigned areas.
• Provides subject matter expertise related to quality initiative implementation, reporting and analysis.
• Acts as a liaison between internal/external customers and Information Technology for business definition, scope, testing and implementation.
• Ensures quality, efficiency, effectiveness, and customer knowledge to improve business practices.
• Possesses a high degree of operational knowledge as it relates to customer operations in claims, system administration, expansion business, and member enrollment.

Senior Business Analyst – Operations

Analyst

• Provide day-to-day support and optimization of Epic Inpatient clinical applications, including system builds, upgrades and enhancements
• Analyze inpatient clinical and operational workflows to identify opportunities for optimization and improved patient care outcomes
• Partner with clinicians, nursing leadership, and operational teams to gather requirements and translate clinical needs into Epic Inpatient solutions
• Perform and document workflow assessments to determine functional and clinical requirements for optimal system utilization
• Develop and execute system test plans for Epic Inpatient upgrades and enhancements; document test results and outcomes
• Manage problem, incident, and change management processes related to inpatient clinical systems
• Provide daily on-call support for inpatient application-related issues as required
• Communicate system issues, enhancements, and workflow changes clearly to clinical and operational stakeholders.
• Oversee smaller-sized projects or components of projects.
• Coordinate implementation or project planning around software application releases.

IT Specialty Analyst – Epic

General

• Responsible for the investigation and documentation of member appeals and grievances in compliance with State law, applicable rules and regulations and provider and group agreements.
• Works closely with the Plan's Medical Directors who are responsible for all decision regarding clinical appeals/ grievances and the Appeals Manager who is responsible for non-clinical appeals and grievances.

Member Appeals and Grievances Coordinator

Manager

• Supports daily operations within the practice by providing supervision
• Performs administrative tasks
• Manages functions to create an efficient work environment
• Acts as lead during Practice Manager’s absence
• Provides supervision and work assignments to staff based on practice needs
• Provides guidance regarding employee relations and staffing issues
• Processes time to ensure success of practice and management by providing overall support
• Manages multiple projects and performs work assignments as needed

Assistant Manager

Pharmacist

• Participates in all aspects of the medication-use system while delivering comprehensive and personalized pharmaceutical care to patients in their designated areas.
• Assumes leadership and accountability for specific clinical pharmacy areas.
• Demonstrates advanced skills and expertise, and obtains advanced certification in their practice area if available.
• Manages patient drug therapy in accordance with applicable clinical practice standards.
• Assures the appropriateness of all provider medication orders in maintaining a high level of patient care and safety.
• Maintains advanced knowledge of medication use, disease states, and regulations applicable to their area of practice.
• Serves as the primary resource for drug information and education.
• Provides in-depth patient counseling when required.
• Supports the training of new employees and participates in the creation and maintenance of training materials.
• Assumes local and system responsibility and ownership for assigned tasks.
• Follows and assists with the development of policies and procedures.
• Demonstrates superior customer service, effective communication, decision-making, and organization to ensure efficient job performance and success.
• Ensures adequate supplies are available for continuous patient care.
• Triages and escalates any questions or issues outside the scope of practice as needed.
• Uses appropriate systems for processing of patient information.
• Ensures quality assurance is maintained according to departmental and legal requirements.
• Precepts pharmacy students and/or pharmacy residents as assigned.
• Provides peer coaching and constructive feedback to other colleagues in a professional and productive manner.
• Successfully leads local and system implementation of various system initiatives.
• Serves as a system expert and site lead in specialized clinical pharmacy functions.