City / State
Norfolk, VA
Overview
Work Shift
First (Days) (United States of America)
Sentara Health is hiring for a Performance Measurement Specialist II
This is a Full-Time position, fully remote, with day shift hours and great benefits!
Work Location :
Remote opportunities available 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 (state), West Virginia, Wisconsin, Wyoming.
For applicants within Maryland, Nevada, Ohio and Washington States, the following hiring range will be applied : $43,942.
08 to $51,891.84 annually with a target hiring range of $43,942.08 to $65,913.12 .
Job Responsibilities
The position is responsible for the execution of operations random and focus audits. Assess company operations, process, compliance and other associated risks.
Prepare and present quality reports of audit findings and recommendations to Manager and customers. Develop strategic initiatives to maintain and improve the audit function.
Evaluate and revise internal controls and operational and management policies / procedures. Support External Audits for CMS, DMAS, and Groups .
Job Requirements :
- 3 years' experience in Claims Processing, Customer Service, Enrollment or System Administration required.
- Sales experience preferred, not required.
Benefits :
Sentara employees strive to make our communities healthier places to live. We’re setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.
For more information about our employee benefits,
About the Company :
Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider. Offering hundreds of sites of care including 12 hospitals and multiple services that supports 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!
Sentara Healthcare 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.
Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity.
Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search : JR-58651
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Keywords : Performance Measurement Specialist, Health plan, Health care, Claims, claims processing, enrollment, system administration, CMS, DMAS, Remote, 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 (state), West Virginia, Wisconsin, Wyoming
Job Summary
The position is responsible for the execution of operations random and focus audits. Assess company operations, process, compliance and other associated risks.
Prepare and present quality reports of audit findings and recommendations to Manager and customers. Develop strategic initiatives to maintain and improve the audit function.
Evaluate and revise internal controls and operational and management policies / procedures. Support External Audits for CMS, DMAS, and Groups .
3 years experience in Claims Processing, Customer Service, Enrollment or System Administration required. (Not required for Sales Positions)
Sales experience preferred, not required.
Qualifications :
HS - High School Grad or Equivalent (Required)Accounting / Auditing
Skills
Communication, Instructing, Microsoft Office, Speaking
Sentara Healthcare 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.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.
gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a tobacco-free environment.
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