Req ID: RQ179487

Type of Requisition: Regular

Clearance Level Must Be Able to Obtain: None

Job Family: Healthcare Claims

Skills:

Health Care,Insurance,Medicaid,Provider Enrollment,State Medicaid

Experience:

5 + years of related experience

Job Description:

We are GDIT. We take pride in providing our clients with world class customer support. By joining our team in supporting the Federal Civil Division State and Local Health team for a state Medicaid, you will be delivering insights to help our clients make impactful changes real. By owning your opportunity at GDIT, you’ll become a critical part in how we successfully solve our clients’ biggest challenges. GDIT delivers exceptional solutions and services that enable the safety, security, health and well-being of our nation.

As a Provider Enrollment Manager on the GDIT Federal Civil Division State and Local Health team for a state Medicaid program which was awarded in January 2023, you will be supporting the program that will have progressive growth and expansion of services as it is a multi-year program. The program will engage with state customer, subcontracting vendors, and many stakeholder entities. The selected candidate will work with a team who has extensive Medicaid, healthcare, and oversees and manages the provider enrollment process within a healthcare organization, ensuring that healthcare providers are credentialed, contracted, and able to deliver services to patients. The candidate must have Provider Enrollment experience.

Role Summary:

As a Provider Enrollment Manager, you will be responsible for leading and coordinating the provider enrollment and credentialing activities within the organization. You will oversee a team of enrollment specialists, ensuring timely and accurate completion of enrollment processes while maintaining compliance with regulatory requirements and organizational standards.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Team Leadership: Supervise and provide guidance to a team of Provider Enrollment Specialists, including training, coaching, and performance management.

• Enrollment Process Management: Manage the end-to-end provider enrollment process, including initial applications, re-credentialing, and updates to provider information.

• Credentialing Oversight: Ensure providers meet credentialing requirements by verifying education, training, licensure, certifications, and other qualifications.

• Compliance Assurance: Monitor and ensure compliance with regulatory standards, accreditation requirements throughout the enrollment and credentialing process.

• Relationship Management: Build and maintain relationships with internal stakeholders (such as legal, compliance, finance) and external stakeholders (providers, insurance companies) to facilitate efficient enrollment and credentialing processes.

• Process Improvement: Identify opportunities for process improvements and efficiency enhancements within the provider enrollment function, implementing best practices and standard operating procedures.

• Reporting and Analysis: Generate reports and analyze enrollment data to track performance metrics, identify trends, and support decision-making by senior management.

What you’ll need to succeed:

• Previous experience in Medicaid/Medicare provider enrollment, credentialing, or healthcare administration, with at least 5 years in a managerial or supervisory role.

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (required); Master’s degree preferred.

• In-depth knowledge of healthcare regulations, accreditation standards (e.g., NCQA, Joint Commission), and payer requirements.

• Strong leadership and team-building skills, with the ability to motivate and develop a team of enrollment specialists.

• Excellent communication skills, both verbal and written, with the ability to interact effectively with diverse stakeholders.

• Analytical mindset with the ability to interpret data, identify issues, and propose solutions.

• Proficiency in using enrollment software or databases (e.g., CAQH, NPPES) and MS Office Suite.

• Required Technical Skills: Proficiency in the use of word processing, spreadsheet, training software.

• Required Skills and Abilities: Strong written and verbal communication skills, Solid knowledge of Microsoft Office suite, Strong analytical and problem-solving skills, Works independently under general supervision

• Location: Remote however must be in US state

GDIT Is Your Place:

• 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

The likely salary range for this position is $92,331 - $117,734. 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.

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.

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 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 30 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.

We connect people with the most impactful client missions, creating an unparalleled work experience that allows them to see their impact every day. We create opportunities for our people to lead and learn simultaneously. From securing our nation’s most sensitive systems, to enabling digital transformation and cloud adoption, our people are the ones who make change real.

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.