Provider Network Operations Efficiency
OptumInsight provider network operations efficiency solutions help managed care organizations remove administrative costs from necessary and routine network management operations, and help them evaluate networks for optimal coverage and accessibility. Our solutions help organizations to efficiently and effectively manage provider networks aimed at:
-
Positioning your network for better access, competitiveness, and compliance
-
Identifying and recruiting providers who will improve your network’s performance and competitiveness
-
Saving time and money in their credentialing process
-
Maintaining complete and accurate provider demographic data
-
Controlling and distributing provider data according to internal and external demands
Credentialing
OptumInsight’s end-to-end credentialing solutions can increase a health plan’s operational efficiency by automating and streamlining the labor-intensive legwork needed to gather, verify, review, and archive provider credentials. Our credentialing solutions enable health plans to satisfy credentialing requirements while delivering on defined business results and lowering costs.
Select a solution
Network Accessibility
Our industry-leading network accessibility solutions analyze your networks to determine how well they meet your objectives for access, compliance and quality. Then, they strengthen your network competitiveness by identifying providers to expand geographic and specialty areas. Collectively these tools help you evaluate your current accessibility and select the right providers for expansion by giving you immediate access to their history, credentials and quality feedback.
Select a solution
Provider Data Solutions
Provider data touches every facet of a health plan, but with limited resources most plans struggle to maintain an accurate provider database. Our database tools and sophisticated data management services improve processes that depend on complete and accurate provider data. We can help you keep your files updated and maintained to better serve your members and network providers and meet regulatory requirements.
Select a solution
Consulting
Providing better care starts by contracting with the right providers and rewarding them for quality and effectiveness. OptumInsight consulting partners with you to develop your network, integrate provider engagement initiatives with your contracting and payments, perform competitor reimbursement analysis and contract analysis and modeling, and recommend contracting and pricing strategies.
Select a solution