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At Optum, the mission is clear: Help people live healthier 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)Provider Network Relations Specialists must be able to routinely evaluate and analyze the most beneficial solution for LHI and our network providers in a variety of circumstances. Maintain a successful working relationship between LHI and network providers through a full range of provider relations and service interactions to ensure provider retention. Identify and remediate operational short-falls, respond to customer complaints, customer satisfaction surveys and provider questions, and research and resolve accounts payable issues. Routinely negotiate cost effective fees for single services, confirm service capability and educate providers on contract expectations, processes and paperwork. Comprehend detailed knowledge of customer requirements in order to translate subcontractor agreements, contractual requirements and fee agreements to the providers.You'll enjoy the flexibility to either work in office or telecommute as you take on some tough challenges. Primary Responsibilities:- Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, LHI Customers and LHI
- Negotiate fees that align provider needs and LHI business objectives. Educate providers on fee structures to ensure collaborative agreement and understanding of LHI Services and the fees associated with them
- Staff Provider Relations Telephone Queue, adequately respond to and resolve incoming calls in the appropriate manner
- Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame through investigation and problem solving that results in positive outcomes
- Provide explanations and information to others on topics within area of expertise
- Proactively review and maintain provider compliance documents to ensure active status within provider network
- Manually assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code
- Bachelor's Degree in Business, Marketing, Communications or healthcare related field
- 1 + years related experience
- Proficient experience with Word, Excel & Outlook. Word - Create correspondence and work within templates. Excel - Data Entry, Sort/filter and work within tables. Outlook - email and calendar
- High School Diploma/GED
- 3 + years related experience (provider relations, network management, customer service, negotiations, account services and/or account management, etc.)
- Proficient experience with Word, Excel & Outlook. Word - Create correspondence and work within templates. Excel - Data Entry, Sort/filter and work within tables. Outlook - email and calendar
- Knowledge of negotiating rates and managing subcontractor relationships
- Advanced Excel skills with V Lookups, Pivot Tables and utilize formulas is preferred
- Ability to effectively manage provider accounts resulting in provider retention
- Ability to develop strong professional relationships while demonstrating a clear understanding of complex business structures
- National Career Readiness Certificate
- Knowledge of Medical or dental terminology
- Database experience/education a plus
Vacancy expired!