Dedicated Network Operations Specialist - National Remote

$48,298 - $94,494/Yr

UnitedHealth Group - Appleton, WI

Full-time - Entry Level

Remote - Appleton, WI

Insurance Carriers and Related Activities

About the position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. In this role as a Dedicated Network Operations Specialist, you will be responsible for assessing and resolving examiner's concerns, developing and implementing solutions in varied clinical delivery systems as the first line of support for the Dedicated Network. You will escalate issues when appropriate to Operations Management and Vendor Management for further review and resolution. Additionally, you will enter and manage availability into Mednet for all dedicated examiners and continually communicate with Operations Management, POD groups, and other departments to accomplish mission tasks related to achieving contract KPIs. Your role will also involve soliciting provider informal and formal feedback via surveys, complaints, and conversations in order to develop action plans, including corrective actions, suggestions to leadership, and complaint resolution processes. You will 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.

Responsibilities

• Assess and resolve examiner's concerns, developing and implementing solutions in varied clinical delivery systems as the first line of support for the Dedicated Network.
• Escalate issues when appropriate to Operations Management and Vendor Management for further review and resolution.
• Enter and manage availability into Mednet for all dedicated examiners.
• Continually communicate with Operations Management, POD groups, and other departments to accomplish mission tasks related to achieving contract KPIs.
• Solicit provider informal and formal feedback via surveys, complaints, and conversations in order to develop action plans.

Requirements

• High School Diploma/GED (or higher)
• 1+ years of related experience in provider relations and/or network management
• 1+ years of customer service, account services and/or account management with negotiations experience
• 1+ years of proven experience to effectively problem solve while utilizing solid customer service skill sets
• 1+ years of demonstrated experience in speaking clearly and concisely while conveying complex or technical information in a manner that others can understand
• Intermediate level of proficiency with Microsoft Office programs, Adobe or equivalent

Nice-to-haves

• Equivalent combination of education, experience and/or applicable military experience
• Medical, dental, or healthcare insurance experience
• VA knowledge or experience
• Provider relationships resulting in positive provider experience and retention

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution