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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Network Management



Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Relations Specialist (LHI) - La Crosse, WI

UHG - La Crosse, Wisconsin

Posted: 12/12/2018

At Optum, the mission is clear: Help people live heathier 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.


The Provider Relations Specialist will 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. 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.


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.
  • Collaborate with other departments to assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code.

Required Qualifications:

  • Bachelor’s Degree (or higher) in Business, Marketing, Communications or healthcare related field and 1+ years of related experience or High School Diploma / GED and 3+ years of related experience (provider relations, network management, customer service, negotiations, account services and / or account management, etc.)
  • Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables), and Microsoft Outlook (email and calendar)
  • Ability to work an 8 - hour shift between 8:00 am - 6:00 pm Monday through Friday

Preferred Qualifications:

  • Knowledge of negotiating rates and managing subcontractor relationships
  • Advanced Microsoft Excel skills with V Lookups, Pivot Tables and ability to utilize formulas
  • National Career Readiness Certificate
  • Knowledge of Medical or dental terminology
  • Database experience / education

Soft Skills:

  • Strong verbal, written and interpersonal skills
  • Ability to work independently in a fast - paced environment, flexible and adaptable to changing situations
  • Ability to demonstrate an appropriate level of assertiveness in performing work responsibilities and in making work related decisions
  • Ability to influence and negotiate through use of verbal, written and interpersonal means with a diverse group of people / disciplines at all levels of an organization
  • Ability to plan and prioritize effectively
  • Proven ability to effectively problem solve while utilizing strong customer service skill sets
  • 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

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.

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.

Keywords: LHI, La Crosse, WI, provider relations, network management, customer service, negotiations, account services, account management

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