Offer summary

Qualifications:

Bachelor’s Degree required., Minimum 2 years of team management experience., Experience in configuring commercial health plans, with preference for QNXT platform., Strong knowledge of government and commercial reimbursement methods..

Key responsibilities:

Lead a team delivering business solutions for health plan initiatives.

Oversee claims and system administration activities.

Manage configuration and testing projects to ensure platform functionality.

Serve as a liaison between departments to coordinate project scopes and timelines.

Job description

City/State

Richmond, VA

Work 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

Bachelor’s 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

Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans

• Adoption, Fertility and Surrogacy Reimbursement up to $10,000

• Paid Time Off and Sick Leave

• Paid Parental & Family Caregiver Leave

• Emergency Backup Care

• Long-Term, Short-Term Disability, and Critical Illness plans

• Life Insurance

• 401k/403B with Employer Match

• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education

• Student Debt Pay Down – $10,000

• Reimbursement for certifications and free access to complete CEUs and professional development

•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established 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 30,000-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.

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