Be an early applicantLess than 25 applicants

Company

Optum · 18 hours ago

Network Adequacy Specialist - National Remote

La Crosse, WI

Full-time

Remote

Entry Level

$23.22/hr - $45.43/hr

1+ years exp

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EducationHealth Care

H1B Sponsor Likely

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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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Network ManagementCoverage AnalyticsData ManagementDatabase ExperienceAnalyzing Workflow DataMicrosoft OfficeHealthcare Insurance ExperienceAuditing Healthcare Providers

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

Glassdoor

3.6

Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.

Founded in 2011

Eden Prairie, Minnesota, USA

10001+ employees

https://www.optum.com/

H1B Sponsorship

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Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2023 (470)

2022 (822)

2021 (646)

2020 (458)