What are the responsibilities and job description for the Member Appeals and Grievances Coordinator- Remote in Virginia position at Sentara Health?
Physical Location: Norfolk, VA
Location Type: Remote
Employment Status: Regular-Full time
Shift: Multiple Shifts Available
Posted Date: March 10, 2026
Job Overview
Sentara Health Plans is hiring an Member Appeals and Grievances Coordinator- Remote in Virginia!
Status: Full-time, permanent position (40 hours)
Standard working hours: 8am to 5pm EST, M-F.
Location: Remote in Virginia
Job responsibilities:
Responsible for the investigation and documentation of member appeals and grievances in compliance with State law, applicable rules and regulations and provider and group agreements. Works closely with the Plan's Medical Directors who are responsible for all decision regarding clinical appeals/ grievances and the Appeals Manager who is responsible for non-clinical appeals and grievances.
Education:
HS – High School Grad or Equivalent REQUIRED
Certification/Licensure:
None required
Experience:
Managed Care- 3 years REQUIRED
Previous member appeals and grievances experience 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 (Opens in a new tab) and use the following as your Keyword Search: JR-87716
#really
Talroo – Health Plan
Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Remote, Virginia, VA, Appeals, Claims, Grievance, Denials, Pre-authorization, Member
About Us
Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission – “we improve health every day.” Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 34,000 employees, 12 hospitals in Virginia and Northeastern North Carolina including 10 hospitals with the prestigious Magnet® recognition, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Sentara was named a Health Quality Innovator of the Year (2024), was recognized by Forbes as “America’s Best-In-State Employer” (2024), “Best Employer for Veterans” (2022, 2023), and “Best Employer for Women” (2020), and named to IBM Watson Health’s “Top 15 Health Systems” (2021, 2018).
Learn more (Opens in a new tab)