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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), 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!
Overview
The Supervisor, Health Plan Business Systems Operations will lead a team focused on delivering business solutions for complex health plan initiatives, including the configuration and implementation of new markets and products. This role requires strong system analysis, configuration design, testing, and documentation skills, as well as a high level of expertise in supporting governmental and commercial reimbursement policies.
The Supervisor will oversee claims and system administration activities, manage configuration and testing projects, and ensure platform functionality aligns with organizational goals. This individual will serve as a key liaison between departments, ensuring realistic project scopes, effective timelines, and the resolution of barriers. Experience with commercial health plans and strong leadership capabilities are essential. QNXT platform experience is highly preferred.
Education
Bachelor’s Degree (Required)
Certification/Licensure
No specific certification or licensure requirements
Experience
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Minimum 2 years of experience managing people or leading a team
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Experience in the configuration of commercial health plans; QNXT experience preferred
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Strong understanding of government and commercial reimbursement methodologies
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3+ years of experience with MS SQL Server, including writing SQL queries and working with SSAS, SSRS, and SSIS
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Proven ability to retrieve and analyze complex data using Microsoft Access, Excel, and SQL
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Proficient in process mapping/flow charting and documentation best practices
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Demonstrated ability to independently lead multi-functional projects and guide team members
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Strong organizational, verbal, and written communication skills
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Ability to coach, mentor, and manage workload across a team of analysts
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Experience in Managed Care, Medicaid, or Medicare Insurance environments
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Ability to apply sound judgment, troubleshoot complex issues, and influence process improvements
Sentara 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.
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