Provider Relations Specialist – CCE, Network Support

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $85.1k - $97.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🛜 Network Engineer / Network Administrator

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Serve as primary Provider Services point of contact for assigned Clinical Centers of Excellence (CCEs) • Develop working relationships and understand each CCE's provider network and operational needs • Conduct outreach to identify provider concerns, access issues, emerging needs, and service-improvement opportunities • Support provider nominations and referrals by documenting, researching, tracking, and routing requests • Coordinate with Provider Network/Contracting staff regarding practitioners, specialists, facilities, and HDOs • Provide status updates on provider nominations, affiliation, onboarding, and Provider Services activities • Facilitate communication between CCEs and Provider Services on provider participation and operational issues • Support providers and HDOs with WTCHP requirements, operational processes, portal use, Terms & Conditions, roster submission, EFT, enrollment, and participation requirements • Educate providers and CCE stakeholders on WTCHP processes, policies, workflows, and network-participation changes • Coordinate provider onboarding and orientation activities • Research and resolve escalated provider issues and systemic concerns • Partner with Provider Data, Credentialing, Claims, Contracting/Recruitment, and other operational teams • Identify trends in inquiries, escalations, access concerns, and administrative barriers; elevate findings to leadership • Maintain documentation in workflow and tracking systems, including JIRA where applicable • Participate in CCE meetings, operational workgroups, education sessions, and stakeholder forums • Support reporting on CCE engagement, provider nominations, outstanding issues, network access, and resolution turnaround times • Promote a high-touch service model supporting uninterrupted access to care for WTCHP members

🎯 Requirements

• Bachelor's degree preferred or equivalent combination of education and relevant professional experience • Three (3) or more years of experience in provider relations, provider services, healthcare operations, health plan operations, network management, or a related healthcare environment • Experience working directly with provider organizations, hospitals, medical groups, clinical practices, or healthcare program stakeholders strongly preferred • Working knowledge of provider enrollment, credentialing, provider data, contracting/participation, claims, and provider lifecycle processes • Strong relationship-management, communication, presentation, problem-solving, and follow-through skills • Ability to coordinate issues across multiple operational departments while maintaining ownership of the stakeholder experience • Ability to manage multiple priorities, track open items through resolution, and communicate effectively with internal and external stakeholders • Proficiency with Microsoft Office applications preferred • Experience with workflow, CRM, ticketing, or provider management systems preferred • US citizenship is not required • MBI (T2) public trust requirement • Ability to support the New York Metropolitan Area network • Less than 10% travel

🏖️ Benefits

• Comprehensive benefits and wellness packages • 401K with company match • Competitive pay • Paid time off • Medical plan options, some with Health Savings Accounts • Dental plan options • Vision plan options • Full flex work weeks where possible • Vacation, sick, personal time, holiday, paid parental, military, bereavement, and jury duty leave • Typically 15 days of paid leave per calendar year • Additional 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 • AI-powered career tool identifying career steps and learning opportunities • Internal mobility team focused on career goals • Award-winning culture of innovation • Military-friendly workplace • Remote work / telecommuting