About this opportunity
Network Health lists this Provider Integration Representative opportunity in menasha, Wisconsin. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Description
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 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
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.