Provider Enrollment Specialist II

Responsibilities for this Position

Location: USA NC Raleigh
Full Part/Time: Full time
Job Req: RQ222602

Type of Requisition:
Regular

Clearance Level Must Currently Possess:
None

Clearance Level Must Be Able to Obtain:
None

Public Trust/Other Required:
None

Job Family:
Ancillary Health

Job Qualifications:

Skills:
Credentialing, Medicaid Programs, Provider Enrollment, Time Management
Certifications:
None
Experience:
1 + years of related experience
US Citizenship Required:
No

Job Description:

General Dynamics Information Technology created the premier provider of high-tech IT solutions to the government IT market. Together as General Dynamics Information Technology, we deliver cost-effective, next-generation IT solutions and services to the Department of Defense, the intelligence community and federal civilian agencies as they modernize their information systems.

GDIT is currently seeking a Provider Enrollment Specialist II in Raleigh NC to join our team. In this role you will be a change agent by conducting operational audits and verifying that operational procedures are followed correctly for the Provider Enrollment Section. This section is responsible for enrolling providers for the NC Medicaid Programs. This involves ensuring that providers are licensed and accredited for the services enrolling to provide and do not have a criminal background. This is a hybrid role, 1 day in the office.

RESPONSIBILITIES:

• Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within NC State regulations.
• Validate the qualifications of licensed professionals, organizational members or organizations
• Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
• Perform and assess the background check through Lexis Nexis, AAR and PPTD.
• Perform source verification of licensure, certification, endorsements and accreditations through Lexis Nexis or State Licensure Board.
• Deny providers that do not meet the requirements.
• Meet performance quality standards on a daily basis.
• Meet performance quantity standards on a daily basis.

QUALIFICATIONS:

• HS/GED; 2+ years of experience
• Requires 2 years administrative experience
• Knowledge of NC Medicaid or Healthcare
• Working knowledge of NCTracks
• Working knowledge or provider enrollment pega
• Working knowledge of provider enrollment requirements
• Proficient with Microsoft suite

Desired Skills and Experience:

• Credentialing experience
• Customer service experience
• Attention to detail
• Strong verbal and written communication

ATTRIBUTES FOR SUCCESS:

As a trusted systems integrator for more than 50 years, General Dynamics Information Technology provides information technology (IT), systems engineering, professional services and simulation and training to customers in the defense, federal civilian government, health, homeland security, intelligence, state and local government and commercial sectors. With approximately 32,000 professionals worldwide, the company delivers IT enterprise solutions, manages large-scale, mission-critical IT programs and provides mission support services. GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.

The likely hourly rate for this position is between $18.50 - $20.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Weekly Scheduled Hours:

40

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able To Obtain:

None

Public Trust/Other Required:

None

Travel Required:

None

Telecommuting Options:

Hybrid

The likely hourly rate for this position is between $17.57 - $23.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:
40

Travel Required:
None

Telecommuting Options:
Hybrid

Work Location:
USA NC Raleigh

Additional Work Locations:

Total Rewards at GDIT:
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

Our Identify Verification Process:
As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

About our Work:
We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

Join our Talent Community to stay up to date on our career opportunities and events at
gdit.com/tc .

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

PI285400952

General Dynamics Information Technology created the premier provider of high-tech IT solutions to the government IT market. Together as General Dynamics Information Technology, we deliver cost-effective, next-generation IT solutions and services to the Department of Defense, the intelligence community and federal civilian agencies as they modernize their information systems.


GDIT is currently seeking a Provider Enrollment Specialist II in Raleigh NC to join our team. In this role you will be a change agent by conducting operational audits and verifying that operational procedures are followed correctly for the Provider Enrollment Section. This section is responsible for enrolling providers for the NC Medicaid Programs. This involves ensuring that providers are licensed and accredited for the services enrolling to provide and do not have a criminal background. This is a hybrid role, 1 day in the office.



RESPONSIBILITIES:

• Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within NC State regulations.
• Validate the qualifications of licensed professionals, organizational members or organizations
• Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
• Perform and assess the background check through Lexis Nexis, AAR and PPTD.
• Perform source verification of licensure, certification, endorsements and accreditations through Lexis Nexis or State Licensure Board.
• Deny providers that do not meet the requirements.
• Meet performance quality standards on a daily basis.
• Meet performance quantity standards on a daily basis.

QUALIFICATIONS:

• HS/GED; 2+ years of experience
• Requires 2 years administrative experience
• Knowledge of NC Medicaid or Healthcare
• Working knowledge of NCTracks
• Working knowledge or provider enrollment pega
• Working knowledge of provider enrollment requirements
• Proficient with Microsoft suite

Desired Skills and Experience:

• Credentialing experience
• Customer service experience
• Attention to detail
• Strong verbal and written communication

ATTRIBUTES FOR SUCCESS:


As a trusted systems integrator for more than 50 years, General Dynamics Information Technology provides information technology (IT), systems engineering, professional services and simulation and training to customers in the defense, federal civilian government, health, homeland security, intelligence, state and local government and commercial sectors. With approximately 32,000 professionals worldwide, the company delivers IT enterprise solutions, manages large-scale, mission-critical IT programs and provides mission support services. GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.


The likely hourly rate for this position is between $18.50 - $20.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.



Weekly Scheduled Hours:


40



Clearance Level Must Currently Possess:


None



Clearance Level Must Be Able To Obtain:


None



Public Trust/Other Required:


None



Travel Required:


None



Telecommuting Options:


Hybrid


The likely hourly rate for this position is between $17.57 - $23.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.



Scheduled Weekly Hours:
40



Travel Required:
None



Telecommuting Options:
Hybrid



Work Location:
USA NC Raleigh



Additional Work Locations:



Total Rewards at GDIT:
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.



Our Identify Verification Process:
As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.



About our Work:
We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.


Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc .


Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

PI285400952