Our Capabilities

Sentara AdvantEDGESM partners with like-minded health systems in markets outside of Virginia and with other integrated delivery care systems to generate health solutions. When you work with our organization, you are engaging directly with subject matter experts, not a middle man.

With more than 30 years of successful health plan operational experience, we offer:

Joint venture health plan development:

  • Financial business case
  • Staffing plan
  • Implementation plan
  • Legal services for licensure, partner contracting development, etc.

Operations and state-of-the-art infrastructure:

  • Customer service call center
  • Claims processing
  • Benefit design and set up
  • Provider fee schedule analysis and set up

Provider network development:

  • Physician recruitment and contracting
  • Hospital contracting
  • Provider network education and maintenance
  • Pharmacy contracting and management

Product design:

  • Creation of employee wellness and incentive plans
  • Benefit plan design, meeting all federal and state requirements
  • Actuarial and underwriting services aligned under federal requirements

Care management services:

  • Stratification of membership by health status
  • Care and disease management workflow tools
  • Population health and data analytics technology