Provider Credentialing Supervisor
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Job Description
Provider Credentialing Supervisor supporting GDIT’s government healthcare credentialing programs. Managing verification, compliance, workflows, implementation, and stakeholder operations.
Responsibilities:
- Serve as the primary operational contact for government stakeholders regarding credentialing operations
- Support implementation of new credentialing processes and system enhancements
- Document business requirements and translate operational workflows for technical teams
- Perform initial credentialing and recredentialing activities
- Complete Primary Source Verification for required credentialing elements
- Review provider applications for completeness and compliance
- Prepare credentialing files for committee review
- Ensure files meet organizational, CMS, and NCQA standards
- Develop and maintain standard operating procedures
- Participate in workflow design and process improvement initiatives
- Assist with User Acceptance Testing during system implementations
- Identify workflow gaps and recommend operational improvements
- Collaborate with IT, compliance, operations, and government stakeholders
- Maintain credentialing documentation and audit readiness
- Monitor credentialing timelines and established turnaround times
Requirements:
- 3+ years of related experience
- Experience with documentation review
- Experience with operational requirements
- Experience developing and maintaining standard operating procedures (SOPs)
- Knowledge of provider credentialing operations
- Knowledge of Primary Source Verification (PSV)
- Knowledge of CMS and NCQA standards and requirements
- Ability to document business requirements and operational workflows
- Ability to support User Acceptance Testing (UAT)
- MBI (T2) public trust requirement
- No US citizenship required
Benefits:
- Medical plan options, including plans with Health Savings Accounts
- Dental plan options
- Vision plan
- 401(k) plan with pre-tax and post-tax contributions and company match
- Full flex work weeks where possible
- Paid vacation, sick, and personal time
- Paid holidays
- Paid parental leave
- Paid military leave
- Paid bereavement leave
- Paid jury duty leave
- Typically 15 days of paid leave per calendar year
- Typically 10 paid holidays per year
- Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees
- Short- and long-term disability benefits
- Life insurance
- Accidental death and dismemberment insurance
- Personal accident insurance
- Critical illness insurance
- Business travel and accident insurance
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