Provider Enrollment Certification Auditor/Documentation Specialist

General Dynamics Information Technology•USA NC Home Office (NCHOME), NC

6d•$55,806 - $71,300•Hybrid

About The Position

The Provider Enrollment Certification Auditor/Documentation Specialist supports GDIT’s business and mission outcomes through documentation management, process improvement, healthcare operations, provider enrollment, and credentialing expertise. The role develops and maintains operational documentation, interprets policy and regulatory changes, and supports provider profile review and Credentialing Committee activities. It also contributes to quality, compliance, accreditation, cross-functional collaboration, and continuous improvement efforts. The specialist creates and revises desk procedures, policy interpretations, operations manuals, workflow documentation, training materials, and other operational references. The position analyzes policy, business-rule, system, and process changes to determine documentation impacts; maintains document repositories and revision records; and audits materials for accuracy, consistency, and currency. The role also serves as a departmental resource for documented requirements and procedures. The position develops and quality-checks provider profiles and supporting materials for Credentialing Committee review, participates in profile review meetings, and provides documentation support at weekly committee meetings. As needed, it backs up the Credentialing Committee Coordinator with meeting preparation, scheduling, records, and minutes. The specialist collaborates with Operations, Credentialing, Compliance, Quality, IT, leadership, and other stakeholders to ensure documentation reflects current practices and applicable requirements. The role requires a BA/BS degree or equivalent and at least two years of related experience. The listed salary range is $55,806–$71,300, subject to experience, geographic location, and potentially contractual requirements. The schedule is 40 hours per week, with hybrid telecommuting options and a work location listed as any location/remote. Travel is not required.

Requirements

BA/BS degree or equivalent.
At least 2 years of experience in technical writing, process documentation, healthcare operations, credentialing, provider enrollment, quality management, or a related field.
Technical and procedural writing skills.
Proficiency with Microsoft Word, Excel, PowerPoint, and SharePoint.
Experience with process mapping and workflow documentation.
Knowledge of document version control and records management.
Data analysis and reporting skills.
Strong attention to detail and quality-review skills.
Ability to interpret and document complex business processes.
Strong organizational and project coordination skills.
Excellent written and verbal communication skills.
Experience creating and maintaining desk procedures, enrollment manuals, operational policies, job aids, and training materials.
Ability to develop provider profiles and supporting documentation for Credentialing Committee review.
Ability to manage multiple priorities and meet deadlines in a fast-paced operational environment.
Ability to collaborate with cross-functional teams to support compliance, quality, and operational excellence.

Nice To Haves

Experience supporting provider enrollment, credentialing, Credentialing Verification Organization (CVO) activities, NC Medicaid, NCQA, CMS, or healthcare regulatory environments.

Responsibilities

Create and revise desk procedures, policy interpretations, operations manuals, and supporting documentation.
Analyze business-rule changes, policy updates, system enhancements, and operational process changes to determine documentation impacts.
Review Functional Modification Requests submitted by customers and business stakeholders and identify needed documentation updates.
Collaborate with operational teams, business owners, leadership, and subject matter experts to gather information for document development.
Ensure documentation is clear, concise, standardized, and compliant with formatting and version-control requirements.
Maintain document inventories and repositories so staff can access current versions.
Audit existing documentation to identify outdated processes, conflicting instructions, and areas needing clarification.
Track revisions and maintain records of document updates, approvals, and implementation dates.
Review policy and regulatory changes for operational impact and translate complex policy language into procedures and staff guidance.
Align documentation with NC DHHS, NCQA, and organizational requirements, and recommend process improvements based on policy and regulatory changes.
Serve as the departmental resource for locating and interpreting documented business rules, operational requirements, and procedures.
Respond to staff and leadership questions and provide guidance on procedure interpretation and policy application.
Create provider profiles for Credentialing Committee review and check provider files and supporting documentation for accuracy, completeness, and compliance.
Analyze credentialing information, summarize findings for committee consideration, and quality-review profiles before presentation.
Redact confidential, protected, or sensitive information according to organizational policies and privacy requirements.
Participate in daily provider profile review meetings, present profile content, address questions, and work with credentialing leadership to resolve discrepancies and documentation concerns.
Prepare provider profiles for final presentation and attend weekly Credentialing Committee meetings to provide documentation support and answer questions.
Document committee feedback that requires profile updates or process improvements.
Back up the Credentialing Committee Coordinator, including assisting with meeting preparation, agendas, scheduling, communications, meeting materials, minutes, and records.
Support NCQA, CVO, and organizational quality initiatives; update documentation for accreditation standards, audit findings, corrective actions, and process improvements.
Assist with accreditation surveys, audits, and compliance reviews, and collaborate on documentation-related corrective actions.
Partner with Operations, Credentialing, Compliance, Quality, IT, and Leadership to keep documentation aligned with current business practices.
Participate in meetings, workgroups, and project discussions; communicate documentation changes and provide education to affected staff.
Develop procedural guidance and reference materials to support training initiatives.
Identify opportunities to improve document management and operational efficiency, and recommend improvements to standards, templates, and governance practices.
Monitor recurring questions, trends, and audit findings for documentation gaps, and support process redesign, system implementation, and workflow optimization.

Benefits

Comprehensive benefits and wellness packages.
401(k) with company match.
Competitive pay and paid time off.
Full-flex work weeks where possible.
Medical plan options, including plans with Health Savings Accounts.
Dental plan options.
Vision plan.
Paid vacation, sick and personal time, holidays, parental leave, military leave, bereavement leave, and jury duty leave.
Typically 15 days of paid leave per calendar year for new employees, prorated based on hire date.
An additional 10 paid holidays per year, prorated based on hire date.
Paid Family Leave of up to 160 hours in a rolling 12-month period for eligible employees.
Short- and long-term disability benefits.
Life, accidental death and dismemberment, personal accident, critical illness, and business travel and accident insurance provided or available.
AI-powered career tool for career steps and learning opportunities.
Internal mobility team supporting career goals.