Qualified Health Plan (QHP) & Business Support Manager

Sentara; United States; Remote; USD 60,000 - 80,000; Full time

Job description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring a Qualified Health Plan (QHP) & Business Support Manager - Remote!

Status: Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

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!

Job responsibilities:

The Qualified Health Plan (QHP) & Business Support Manager leads and conducts the completion of templates and binders for Qualified Health Plan (QHP) submission. This role ensures alignment of business processes with state and federal regulatory requirements, while collaborating with internal stakeholders and SMEs, and coordinating and assessing the impacts of program changes tied to QHP requests from the state and federal regulators. Creates a thorough understanding of contractual, regulatory and timing requirements for QHP products. The QHP & Business Support Manager also assists with and/or leads market analysis, competitive research, product/benefit and business support activities, as assigned.

Education:

• Five years or more related experience supporting responses to regulatory submission requirements, project management and/or market research analysis is acceptable in lieu of degree.
• BLD - Bachelor's Level Degree preferred

Certification/Licensure:

• None required

Experience:

• Project Management - 2 years experience REQUIRED
• Strategic Planning - 1 year experience REQUIRED
• Market Analysis - 2 years experience REQUIRED
• Intermediate proficiency in Excel (Pivot tables, SQL and Visual Basic) preferred
• Health Plan experience preferred
• Relevant experience in Compliance/Audit/Regulatory and Operations (Enrollment, Claims) preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

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.

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!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-76580

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.