Optum · 1 day ago
Network Adequacy Specialist - National Remote
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Responsibilities
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 other 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 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
Qualification
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Required
High School Diploma / GED (or higher)
1+ year of related experience with network management, coverage analytics, data management, and/or customer service
1+ year of experience with Database experience (i.e. Med Net)
1+ year of experience with demonstrating the ability to analyze, interpret and translate workflow and provider network data
Intermediate level of proficiency with Microsoft Office programs
Preferred
2+ years of related experience (network management, coverage analytics, data management and/or customer service)
Medical, dental or healthcare insurance experience
Experience with auditing and analyzing healthcare providers
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (470)
2022 (822)
2021 (646)
2020 (458)
Funding
Current Stage
Late StageRecent News
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2024-12-04
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