Provider Integration Representative

Network Health WI

Provider Integration Representative maintaining provider data and credentialing for Network Health, a Wisconsin healthcare organization. Supporting onboarding, audits, inquiries, and process improvements through hybrid home-office work.

Posted 8/4/2026full-timeMenasha • Wisconsin • 🇺🇸 United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in maintaining provider demographic and credentialing data while ensuring compliance with NCQA and CMS standards. Proficient in process improvement and automation within provider operations.

Highest-signal resume keywords

Credentialing ExperienceProvider Data ManagementNCQA ComplianceMicrosoft Excel ProficiencyProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingProvider OperationsData ManagementProcess DocumentationDatabase Knowledge

Soft Skills

Problem SolvingCommunicationCollaboration

Tools & Technologies

Microsoft WordMicrosoft ExcelQuickBaseEcho Credentialing Software

Industry Keywords

Managed CareProvider DataNCQACMSSecurity Policies

Tech Stack

Tools & technologies

SQLSSIS

About the role

Key responsibilities & impact

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
Respond to provider/interdepartmental inquiries via email, phone, etc.
Aid in maintaining 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

Requirements

What you’ll need

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
Experience or knowledge of Microsoft Word, Excel, QuickBase, and Echo Credentialing Software
Candidates must reside in the state of Wisconsin
Reliable internet required for home-office work
Compliance with NCQA, CMS, delegation, organizational standards, and security policies

Benefits

Comp & perks

Eligible to work from your home office
Paid to volunteer in your local neighborhood