Provider Relations Supervisor [Remote]
Gdit
- Remote job
Public Trust: MBI (T2)
Requisition Type: Regular
Your Impact
Own your opportunity to be on the frontlines of health innovation. Deliver for America’s health agency missions and enhance lives for hundreds of millions every day.
Job Description
The Provider Network Supervisor is the manager responsible for the strategy, operations, and outcomes of the Provider Relations function supporting the World Trade Center Health Program (WTCHP).
This role leads a team of Provider Network Representatives to onboard and engage providers, deliver education and portal training, resolve issues impacting claims and participation, and maintain strong relationships across the network. The Supervisor partners closely with Provider Data, Credentialing, Contracting, Claims, Clinical Operations, Communications, and IT to ensure operational excellence and a high‑quality provider experience.
Key Outcomes & Success Metrics
- Provider satisfaction: Achieve targeted satisfaction scores; improve first‑contact resolution; reduce escalations and repeat issues.
- Onboarding timeliness: Meet/exceed SLAs for onboarding and participation activation; shorten cycle times; eliminate avoidable delays.
- Issue resolution performance: Decrease average issue aging and backlog across claims, credentialing, enrollment, provider data, contracts, and portal support.
- Portal adoption & engagement: Increase portal registration, self‑service utilization, EFT enrollment, and webinar attendance.
- Quality & compliance: Maintain audit‑ready documentation; raise quality scores; sustain SLA compliance; reduce corrective‑action findings.
- Productivity & effectiveness: Demonstrate year‑over‑year gains in staff productivity, training completion, and adherence to standardized workflows.
Essential Duties & Responsibilities
Leadership & Strategy
- Work in conjunction with the Provider Services Lead on Provider Relations strategy and annual operating plan; translate organizational goals into targets, roadmaps, KPIs, and staffing/resource plans.
- Lead, coach, and develop Provider Network Representatives; set performance goals, conduct evaluations, provide ongoing coaching, and promote professional development.
- Establish governance for escalation pathways, service levels, templates, and communication standards.
Provider Relationship Management
- Oversee account management for healthcare delivery organizations and independent providers.
- Serve as the escalation point for complex provider issues; drive timely resolution and communicate outcomes and prevention plans.
- Monitor provider sentiment and satisfaction; synthesize feedback themes; implement action plans to improve the provider experience.
Provider Onboarding & Education
- Direct end‑to‑end onboarding, provider education, webinars, portal training, EFT setup, credentialing coordination, and directory validation.
- Standardize onboarding checklists, timelines, and handoffs with Credentialing, Provider Data, and Contracting ; ensure accurate participation activation and directory integrity.
- Develop targeted training and communications for provider segments and roles; measure adoption, comprehension, and impact on operational metrics.
Provider Operations & Issue Resolution
- Oversee intake and resolution of issues spanning claims, credentialing, enrollment, provider data, contracts, and portal support ; manage queues and case aging.
- Remove blockers, rebalance work, and escalate cross‑functional dependencies; ensure SLA adherence and clear provider communication.
- Lead root‑cause analysis and corrective actions to reduce repeat issues; coordinate with Claims, Data, and IT on systemic fixes and configuration updates.
Analytics, Reporting & Continuous Improvement
- Develop dashboards and routine reporting on satisfaction, first‑contact resolution, onboarding timeliness, issue aging, portal adoption, quality scores, productivity, and SLA compliance.
- Drive continuous improvement across intake, documentation, handoffs, and communication; implement automation or templates where feasible.
- Use data insights to prioritize provider outreach, education topics, and process enhancements; present recommendations and action plans to leadership.
Cross‑Functional Collaboration
- Partner with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT on shared initiatives and process improvements.
- Align provider communications with contracting terms, credentialing requirements, portal capabilities, and claims processes; ensure consistency and clarity.
- Lead provider meetings and cross‑functional workgroups; track actions to completion and report outcomes.
Risk, Compliance & Stakeholder Management
- Ensure compliance with organizational policies, privacy/security requirements, and applicable regulations; maintain audit‑ready documentation.
- Support audits and quality reviews; develop corrective action plans and monitor remediation; maintain confidentiality of provider information.
- Communicate status, risks, and recommendations to executive stakeholders; prepare materials for business reviews and governance committees .
What you'll Need:
- Bachelor’s degree required; Master’s preferred.
- 7–10 years of experience in provider relations/network operations or related provider‑facing functions (onboarding, education, escalation management).
- 3+ years of supervisory/people leadership experience leading provider relations or customer operations teams.
- Demonstrated expertise in provider engagement, onboarding, education, and issue resolution; strong analytical and written/verbal communication skills.
- Proficiency with provider portals, CRM/case management tools, and collaboration platforms; advanced Excel/Sheets capability.
Preferred
- Experience supporting federal or government‑sponsored healthcare programs.
- Familiarity with provider directory and credentialing requirements; exposure to claims operations and EDI.
Skills & Competencies
- Relationship management and stakeholder communication; executive presence.
- Operational excellence: organization, prioritization, attention to detail, and SLA discipline.
- Analytical thinking; data‑driven decision‑making; dashboard and metric fluency.
- People leadership: coaching, talent development, and performance management.
- Process improvement and change management.
Work Requirements
Years of Experience
3 + years of related experience
* may vary based on technical training, certification(s), or degree
Certification
Travel Required
Less than 10%
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