The Provider Integration Representative will support personnel for Credentialing
and Provider Informatics. This role is responsible for aiding provider data
management, provider credentialing needs, and maintenance of accurate provider
information across all lines of business. This role supports provider
onboarding, credentialing, recredentialing, provider data integrity, regulatory
compliance, and provider inquiries while ensuring compliance with NCQA, CMS, and
organizational standards.
Location: Candidates must reside in the state of Wisconsin for consideration.
This position is eligible to work at your home office (reliable internet is
required). Travel to the corporate office in Menasha is required occasionally
for the position, including on first day.
Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday
Check out our 2025 Community Report
[https://www.youtube.com/watch?v=Oea3uHW0EV0]https://networkhealth.com/__assets/pdf/2025_annual_report.pdf to
learn a little more about the difference our employees make in the communities
we live and work in. As an employee, you will have the opportunity to work hard
and have fun while getting paid to volunteer in your local neighborhood. You
too, can be part of the team and making a difference. Apply to this position to
learn more about our team.
Job Responsibilities:
Maintain accurate provider demographic, contract and credentialing data
across systems
Coordinate and aid in credentialing, recredentialing and ongoing monitoring
needs
Research and resolve provider data discrepancies and respond to provider
inquiries
Support NCQA, CMS, delegation and audit requirements
Responding to provider/interdepartmental inquires via email, phone, etc.
Aid in maintain credentialing policies, desk references and process
documentation
Partner with internal departments and provider offices to resolve issues
Identify and implement process improvements and automation opportunities
Protect confidential information and comply with organizational security
policies
Perform additional duties as assigned
Job Requirements:
High school diploma required
Associate degree in Business, Medical Staff Services, Insurance or related
field preferred or equivalent experience
One or more years of experience in managed care, provider data,
credentialing, or provider operations
Some knowledge of databases, word processing and spreadsheet applications
(Microsoft Word, Excel, QuickBase, and Echo Credentialing Software)
Network Health is an Equal Opportunity Employer