UnitedHealth Group Network Program Specialist (LHI) - Telecommute in La Crosse, Wisconsin
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 6 leader.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Help develop enterprise-wide Clinically Integrated Network teams that focus on specific clinical areas/service lines such as oncology or cardiology
Perform network analysis and strategy development and implementation
Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
Obtain, validate and analyze data as you analyze network availability and access
Recommend utilization or expansion of networks for various products
Calling Members to provide updates on the provider network, and calling Providers to confirm accepted insurance
This is no easy task. There are a lot of details to manage, key projects to support, a heavy administrative role and reliance on your analysis to drive committee decisions.
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.
Undergraduate degree or equivalent work experience
2+ years experience with network data management in a managed care environment
2+ years experience in provider data analysis
2+ years experience with claims processing or resolution and medical coding
1+ years experience working with reporting tools and generating effective reports
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
• 2+ years experience with claims processing systems and provider databases as well as claims system testing
• Project management experience
• Ability to convey complex information to others and make it more easily understood
Building diverse, high quality provider networks is creating greater access to health care and improving the lives of millions. Join us. Learn more about how you can start doing your life's best work.SM
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 salary range for Colorado residents is $43,200 to $76,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*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: claims, data, analysis, network, provider network, provider, analyst, customer service, health plan, medical