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:
Process and Operational Efficiency
Job Qualifications
Skills
Collaboration, Customer Problem Solving, Customer Service, Microsoft Applications, Multitasking
Certifications
None
Experience
1 + years of related experience
US Citizenship Required
No
Job Description:
The Provider Relations Representative serves as the frontline liaison between the World Trade Center Health Program (WTCHP) and participating healthcare delivery organizations. The role is responsible for provider onboarding, education, issue resolution, relationship management, provider engagement and satisfaction, and coordination of operational support activities. The Representative partners with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT to deliver consistent, high‑quality provider experience and ensure operational excellence.
Key Outcomes & Success Metrics
- Provider satisfaction & first‑contact resolution: Achieve targeted satisfaction scores and FCR; reduce escalations and repeat issues.
- Onboarding timeliness: Meet/exceed SLAs for onboarding and participation activation; shorten cycle times and 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 training attendance.
- Communication effectiveness: Improve responsiveness and clarity of provider communications, job aids, and training materials.
- Quality & compliance: Maintain audit‑ready documentation; sustain SLA compliance and quality scores.
Essential Duties & Responsibilities
Relationship Management & Account Ownership
- Serve as the primary point of contact for assigned providers; conduct regular touchpoints and executive‑level check‑ins/QBRs as needed.
- Track provider sentiment and satisfaction; identify themes and drive action plans with the Provider Network Supervisor.
- Document all interactions, decisions, and follow‑ups in CRM/case management tools with clear, accurate notes.
Onboarding & Orientation
- Coordinate end‑to‑end onboarding: welcome materials, portal registration, EFT setup,
- Standardize checklists, timelines, and handoffs with Credentialing, Provider Data, and Contracting to ensure accurate participation activation.
- Monitor onboarding milestones and proactively remove blockers; communicate status and next steps to providers.
Education, Training & Communications
- Deliver provider training (webinars, welcome packets, job aids) on program policies, billing requirements, and operational procedures.
- Tailor content to provider segments and roles; measure adoption and comprehension via attendance, feedback, and follow‑up assessments.
- Maintain a current library of FAQs, guides, and reference materials aligned to process changes.
Issue Intake, Escalation & Resolution
- Resolve escalated provider issues related to claims, credentialing, EFT, enrollment, and portal access; triage and route effectively.
- Follow defined escalation pathways; communicate resolution status, root cause, and prevention actions to providers and internal teams.
- Perform root‑cause analysis for recurring issues and propose corrective actions; track remediation to closure.
- Promote portal features and self‑service workflows; assist with registration, user management, navigation, and troubleshooting.
- Increase EFT adoption and ensure accurate banking/EFT data in coordination with Provider Data and Claims; support verification and updates.
Cross‑Functional Collaboration
- Partner with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT to resolve issues and improve processes.
- Represent provider needs in workgroups; drive action items to completion and report measurable outcomes.
Reporting, Analytics & Continuous Improvement
- Maintain dashboards/logs for satisfaction, first‑contact resolution, onboarding timeliness, case aging, portal adoption, and SLA compliance.
- Analyze trends to prioritize outreach, training topics, and process enhancements; share insights in huddles and business reviews.
- Contribute to continuous improvement initiatives (templates, scripts, automation) to reduce cycle time and error rates.
Compliance, Policy & Documentation Standards
- Ensure adherence to organizational policies and applicable regulations; maintain audit‑ready documentation and records.
- Safeguard provider information (privacy/security); support audits and corrective action plans.
Required Qualifications
- Bachelor’s degree preferred.
- 3+ years in provider relations/provider services or health plan operations (onboarding, education, escalation/issue resolution).
- Strong communication, presentation, facilitation, and relationship‑management skills.
- Proficiency with provider portals and CRM/case management tools; solid Excel/Sheets capability.
- Proven ability to manage multiple priorities, meet SLAs, and produce clear documentation.
Preferred Qualifications
- Experience supporting federal or government‑sponsored healthcare programs.
- Familiarity with claims operations, EDI, credentialing requirements, and provider directory standards.
- Lean/Six Sigma or project management credential (e.g., Green Belt, PMP).
Skills & Competencies
- Relationship building and stakeholder communication; executive presence with provider leaders
- Operational excellence: organization, prioritization, attention to detail, and SLA discipline
- Analytical thinking and data‑driven decision‑making; dashboard fluency
- Conflict resolution, negotiation, and de‑escalation
- Process improvement and change management
- Technical fluency: provider portal, CRM, Excel, and virtual meeting tools
GDIT IS YOUR PLACE
- Full-flex work week to own your priorities at work and at home.
- 401K with company match.
- Comprehensive health and wellness packages.
- Internal mobility team dedicated to helping you own your career.
- Professional growth opportunities including paid education and certifications.
- Cutting-edge technology you can learn from.
- Rest and recharge with paid vacation and holidays.
#GDITFedHealthJobs
#GDITWTCJobs
The likely salary range for this position is $72,877 - $98,599. 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
Less than 10%
Telecommuting Options
Remote
Work Location:
Any Location / Remote
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. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. 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
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Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans