Supervisor, Health Plan Business Systems Operations
Supervisor, Health Plan Business Systems Operations
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Job Description
City/State
Richmond VAWork Shift
First (Days)Overview:
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
Bachelors Degree (Required)
Certification/Licensure
No specific certification or licensure requirements
Experience
Minimum 2 years of experience managing people or leading a team
Experience in the configuration of commercial health plans; QNXT experience preferred
Strong understanding of government and commercial reimbursement methodologies
3 years of experience with MS SQL Server including writing SQL queries and working with SSAS SSRS and SSIS
Proven ability to retrieve and analyze complex data using Microsoft Access Excel and SQL
Proficient in process mapping/flow charting and documentation best practices
Demonstrated ability to independently lead multi-functional projects and guide team members
Strong organizational verbal and written communication skills
Ability to coach mentor and manage workload across a team of analysts
Experience in Managed Care Medicaid or Medicare Insurance environments
Ability to apply sound judgment troubleshoot complex issues and influence process improvements
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished 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 30000-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.
Required Experience:
Manager
Employment Type
Full-Time
