Provider Credentialing Supervisor
$53.31k - $61.53kFull-time
Gdit
Responsibilities for this Position
Location: USA VA Falls ChurchFull Part/Time: Full time
Job Req: RQ226066 Type of Requisition:
Regular Clearance Level Must Currently Possess:
None Clearance Level Must Be Able to Obtain:
None Public Trust/Other Required:
MBI (T2) Job Family:
Ancillary Health Job Qualifications: Skills:
Documentation Review, Document Reporting (Inactive), Operational Requirements, Standard Operating Procedure (SOP)
Certifications:
None
Experience:
3 + years of related experience
US Citizenship Required:
No Job Description: Provider Credentialing Specialist Lead Position Summary The Provider Credentialing Specialist serves as the operational subject matter expert (SME) supporting the design, implementation, and ongoing development of a government healthcare credentialing program. This role partners with government stakeholders, business teams, and technical resources to translate operational requirements into scalable credentialing workflows while ensuring compliance with CMS, NCQA, organizational policies, and regulatory requirements. The position is responsible for implementation activities, provider credentialing operations, primary source verification (PSV), committee preparation, workflow documentation, and serving as the primary operational contact for government clients regarding credentialing processes. Essential Responsibilities
- Serve as the primary operational contact for government stakeholders regarding credentialing operations.
- Support implementation activities for 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 (PSV) for all required credentialing elements.
- Review provider applications for completeness and compliance.
- Prepare credentialing files for committee review.
- Ensure credentialing files meet organizational, CMS, and NCQA standards.
- Develop and maintain standard operating procedures (SOPs).
- Participate in workflow design and process improvement initiatives.
- Assist with User Acceptance Testing (UAT) during system implementations.
- Identify workflow gaps and recommend operational improvements.
- Collaborate with cross-functional teams including IT, compliance, operations, and government stakeholders.
- Maintain credentialing documentation and audit readiness.
- Monitor credentialing timelines and ensure compliance with established turnaround times.
40 Travel Required:
Less than 10% Telecommuting Options:
Remote Work Location:
USA VA Falls Church 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 Identity 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 technology solutions 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 mission-ready capabilities in AI, cloud, cyber and software development. 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
PI286363851
Provider Credentialing Specialist Lead
Position Summary
The Provider Credentialing Specialist serves as the operational subject matter expert (SME) supporting the design, implementation, and ongoing development of a government healthcare credentialing program. This role partners with government stakeholders, business teams, and technical resources to translate operational requirements into scalable credentialing workflows while ensuring compliance with CMS, NCQA, organizational policies, and regulatory requirements.
The position is responsible for implementation activities, provider credentialing operations, primary source verification (PSV), committee preparation, workflow documentation, and serving as the primary operational contact for government clients regarding credentialing processes.
Essential Responsibilities
- Serve as the primary operational contact for government stakeholders regarding credentialing operations.
- Support implementation activities for 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 (PSV) for all required credentialing elements.
- Review provider applications for completeness and compliance.
- Prepare credentialing files for committee review.
- Ensure credentialing files meet organizational, CMS, and NCQA standards.
- Develop and maintain standard operating procedures (SOPs).
- Participate in workflow design and process improvement initiatives.
- Assist with User Acceptance Testing (UAT) during system implementations.
- Identify workflow gaps and recommend operational improvements.
- Collaborate with cross-functional teams including IT, compliance, operations, and government stakeholders.
- Maintain credentialing documentation and audit readiness.
- Monitor credentialing timelines and ensure compliance with established turnaround times.
Vacancy posted 14 days ago
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