Network Adequacy Specialist - Remote
UnitedHealth Group
- La Crosse, WI
- $23.22-45.43 per hour
- Permanent
- Full-time
- Triage orders incoming to provider network to identify network options available to provide service
- 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
- Assign work to others areas of Provider Network as applicable to meet needs of the order/customer
- Provide explanations and information to others on topics within area of expertise
- Track and report contracting efforts in order to successfully monitor pending orders in assigned territories for quick order assignment and scheduling
- Attend POD discussions to speak to held orders that are a work in progress to provide updates to internal and external customers
- Work orders through the Vendor Order Fulfillment process by locating a provider that can perform needed services
- 1+ years of experience in network management, coverage analytics, data management, and/or customer service
- MedNet experience
- Proficient experience with Microsoft Office programs
- Proven solid analytical and problem solving skills with ability work independently
- Proven solid written and verbal communication skills
- Demonstrated ability to analyze, interpret and translate workflow and provider network data
- 2+ years of related experience in network management, coverage analytics, data management and/or customer service
- Medical, dental or healthcare insurance experience
- Experience with auditing and analyzing healthcare providers