At Optum, the mission is clear: Help people live heathier lives and help make the health system work better for everyone.
LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well-being of Americans.
By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system.
LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on-location services, patient-specific in-clinic appointments, telehealth assessments, or any combination based on customer need. LHI's customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing your life's best work.(sm)
The Provider Network Program Specialist (LHI) will perform various activities relevant to analyzing network composition to include: reporting and extracting data for various reports and analyses, identifying provider coverage gaps, identifying potential providers for recruitment, initiating contracting workflows to fill network gaps, and initiating process improvement requests through appropriate channels to facilitate proactive recruitment efforts. Initiate and coordinate audits and corrective activities for data integrity matters. Work collaboratively with leadership staff to assist with the identification of network providers. Support system user testing activities where warranted, as part of operational implementation of new processes or system changes.
The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your expertise and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 7 leader.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Assess and audits provider network coverage, proactively identifying potential providers to meet customer needs and initiating contracting workflows
- Manually assign qualified providers to orders within the contractually allowed mileage radius of the patient’s home zip code. Identify reasons for manual assignment, initiate corrective action for improvements and efficiencies as required
- Provide explanations and information to others on topics within area of expertise
- Track and report contracting efforts and processes via data analysis, identify and initiate efforts for improvements and efficiencies as required
- Obtain, validate and analyze data as you analyze network availability and access
- Recommend utilization or expansion of networks for various products
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- High School Diploma / GED
- 1+ years of related experience in network data management
- Proficient experience with Microsoft Outlook (email and calendar)
- Proficient experience with Microsoft Office (word and excel)
- Ability to convey complex information to others and make it more easily understood
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
- Undergraduate degree or equivalent work experience
- 2+ years of experience with network data management
- 2+ years of experience with claims processing systems and provider databases as well as claims system testing
- 1+ years of experience working with reporting tools and generating effective reports
- 1+ years of professional office and/or healthcare setting
Careers with LHI. Our focus is simple. We're innovators in cost-effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: provider relations, network management, customer service, negotiations, network analysis, LHI, analytics, database, tableau, geo-mapping, Telecommute, Remote, Work from Home