Provider Relations Lead
About The Position
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 Relations Lead 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 managing and maintaining positive relationships between the State of New Mexico Health Care Authority and its network of providers, which can include physicians, hospitals, clinics, Presumptive Eligibility Determiners, and other healthcare facilities.
Requirements
- Bachelor’s degree in Healthcare Administration, Business Administration, or a related field (required) with 5 + years experience
- Previous experience in provider relations, network management, or healthcare administration, with demonstrated leadership experience.
- In-depth knowledge of healthcare regulations, managed care principles, and payer/provider dynamics.
- Strong negotiation, communication, and interpersonal skills, with the ability to build trust and rapport with providers.
- Analytical skills with the ability to interpret data, identify trends, and propose actionable insights.
- Proficiency in using MS Office Suite and experience with CRM software (e.g., Salesforce) is advantageous.
Nice To Haves
- Leadership and managerial skills to effectively lead a provider relations team and drive collaboration.
- Strategic thinking and problem-solving abilities to address complex provider issues and challenges.
- Ability to prioritize tasks, manage multiple projects simultaneously, and meet deadlines.
- Collaboration and teamwork skills to work effectively with internal departments and external stakeholders.
- Adaptability and resilience to navigate changes in healthcare policies and organizational priorities.
Responsibilities
- Lead a team of Provider Relations Specialists, including assigning tasks, providing training and development opportunities, and conducting performance evaluations.
- Develop and maintain strong, collaborative relationships with healthcare providers, including physicians, hospitals, Tribal Organizations, Presumptive Eligibility Determiners, and clinics.
- Serve as a primary point of contact for escalated provider inquiries, issues, and concerns, ensuring timely and effective resolution.
- Educate providers on organizational policies, procedures, and services to enhance their understanding and support compliance.
- Plan and execute communication campaigns to support client’s initiatives and enhance public relations. Ensure consistent messaging and branding across all communication channels and platforms.
- Work with internal and external teams to expand and optimize provider networks, ensuring adequate coverage and quality of services through outreach activities.
- Monitor provider performance metrics and collaborate with internal and external team members to identify opportunities for improvement in service delivery and patient outcomes.
- Ensure providers and provider relations staff adhere to regulatory requirements, contractual obligations, and accreditation standards.
- Generate reports, analyze provider data, and present insights to senior management to support strategic decision-making and improve provider relations strategies.
Benefits
- 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
- variety of medical plan options, some with Health Savings Accounts
- dental plan options
- a vision plan
- 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.
- full flex work weeks where possible
- a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave.
- 15 days of paid leave per calendar year to be used for vacations, personal business, and illness
- an additional 10 paid holidays per year.
- Paid Family Leave program provides a total of up to 160 hours of paid leave 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 are provided or available.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
