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Sentara
- Miami, FL / Gainesville, FL
Prepare, analyze, research, and adjust financial statements for management presentation. Creates relevant work papers, schedules, and reconciliations. Review and comprehend financial indicators and results of operations, significant operational statistics, variances from budget and historical results. Research technical accounting and financial reporting issues, and assis
Posted 2 days ago
Support Sr. Sales Executives and/or Sr. Account Executives in producing and retaining profitable business within small and mid sized segments. Interact with general agents, brokers, benefit administrators, members, and internal resources as needed to achieve profitable growth objectives. HS grad and 5 years related experience. Related years of experience includes Administ
Posted 3 days ago
Cultivate and manage relationships with assigned brokers and territories to achieve profitable net new business objectives. Responsible for managing the entire sales process with assigned brokers and direct prospects or sales leads as assigned by Sales Manager. Bachelor's degree with 2 years of sales experience required, or HS Diploma and 5 years sales experience required
Posted 5 days ago
Sentara
- Miami, FL / Gainesville, GA / Texas City, TX
AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Sr. Underwriter in Miami and/or Gainesville, Florida. This is a hybrid position, 2 days in office and 3 days remote if within local market or 100% remote if outside of local territory. Scope of position The Sr. Underwriter reviews and analyzes risks posed by employer groups requesting group healt
Posted 6 days ago
Sentara
- Gainesville, FL / Miami, FL
Assist in any and all of the functions normally associated with a qualified health actuary including IBNR calculation; the determination of rating factors such as age, sex, location, or industry; development of rates and filings for the BOI; suggestions for periodic group rating changes; development of necessary rates for government programs; assistance with the developme
Posted 8 days ago
Sentara
- Miami, FL / Gainesville, FL
Responsible for managing patient's medical nutrition therapy in accordance with the medical staff approved clinical practice standards for high risk patients. Serves as a resource for nutrition education. Board Certified Specialist in one of the recognized ADA/NATCO/NBNSC specialty certifications Cert Nutrition Support Clinician (CNSC), Renal Nutrition (CSR); Certified Sp
Posted 11 days ago
Sentara
- Gainesville, FL / Miami, FL
Assist in any and all of the functions normally associated with a qualified health actuary including IBNR calculation; the determination of rating factors such as age, sex, location, or industry; development of rates and filings for the BOI; suggestions for periodic group rating changes; development of necessary rates for government programs; assistance with the developme
Posted 16 days ago
The Digital Media Specialist is responsible for the creation and implementation of all manner of content for the Sentara public website, sentara.com, and social/digital media presence in support of the Sentara strategic and marketing goals. Bachelors in business, marketing, public relations, communications, digital media, digital journalism, architecture, or related field
Posted 19 days ago
Cultivate and manage relationships with assigned brokers and territories to achieve profitable net new business objectives. Responsible for managing the entire sales process with assigned brokers and direct prospects or sales leads as assigned by Sales Manager. Bachelor's degree with 2 years of sales experience required, or HS Diploma and 5 years sales experience required
Posted 22 days ago
Sentara
- Miami, FL / Gainesville, FL
The primary role of the Provider Data Enrollment Specialist I is to ensure the data integrity of provider records entered and maintained in the credentialing and/or payment systems. This position may be responsible for all aspects of ensuring accurate and timely processing of provider setup to initiate credentialing, provider record updates and edits, processing provider
Posted 22 days ago
Sentara
- Miami, FL / Gainesville, FL
Responsible for all areas of customer service as it pertains to the acquisition and/ or retention of members for Sentara Health Plan, Inc. This includes functions associated with the administration of all group information processing of claims, interaction with members, providers and employers. Special reports and projects to include initial review and analysis, recommend
Posted 22 days ago
Professional individual who is experienced in high dollar contract negotiations. Independently run effective business meetings. Be able to independently reach out to vendors and customers to provide a high level of service and creative win win negotiating scenarios to benefit all parties. This person will need to analyze proposals effectively and provide summaries and rec
Posted 23 days ago
Under the direction of a Pharmacy Team Coordinator (TC), the Pharmacy Prior Authorization Coordinator II (PAC II) is responsible for supporting the day to day operations for the call center and prior authorization cases for all lines of business (Medicaid, Medicare, Exchange and Commercial). Provides knowledgeable and courteous customer service and response to members and
Posted 24 days ago
Primarily responsible for handling incoming calls to effectively address eligibility, claim, and payment issues. May be required to provide off phone assistance to customers and department leadership. Ability to work in a fast paced environment to assist callers and update billing information, establish payment plans, screen callers for financial assistance, and resolve c
Posted 1 month ago
RN Clinician 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, with the goal of optimizing member health care across the care continuum. Performs telephonic or face to face clinical assessments for the identification, evaluation, coordination and management
Posted 1 month ago
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