Performance Measurement Specialist - Remote (Select States)

City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health Plans is recruiting a Performance Measurement Specialist!

This is a full-time position with the flexibility to work between the hours of 8am to 8pm.

Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming

Job responsibilities:

• Listen to agents' call recordings to ensure compliance with Federal and Departmental rules and regulations
• Provide coaching to agents on score cards
• Provide leadership with WTD, MTD, and YTD audit reports to leadership
• Advise Leadership on any QA trends and provide recommendations

Job requirements:

• Highly Preferred: sales background, sales transaction, sales approach, sales process, and experience with Medicare/Medicaid
• Preferred: Writing and communication skills
• Preferred: Excel knowledge
• Required: Minimum of 2 years related working experience in a customer service and sales role.
• Required: High school diploma or equivalent

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.

Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.

For applicants within Washington State, the following hiring range will be applied: $41,845.44 - 62,768.16/annually.

Headquartered in Virginia Beach, VA, Sentara Health Plans is the health insurance division of Sentara Healthcare, offering health plans through its subsidiaries.

Sentara Health Plans provide health insurance coverage to over 900,000 members through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years' experience in the insurance business and 20 years' experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services - all to help our members improve their health. Wherever we serve our members, Optima Health stands out through our passion for health and service excellence.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and 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!

Job Summary

Responsible for the development and the oversight of the Quality Program Customer Operations Department as well as other departments as applicable. Additional responsibilities include but not limited to project management for internal and external audits, identifying and implementing process improvements to support the business needs. Prepare and track an audit work plan and customize audit solutions for internal and external audits. The Performance Measurement Analyst serves as a resource for Customer Operations/external departments.

2 years experience in Claims Processing, Customer Service, Enrollment or System Administration 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.