Provider Relations Lead

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.  

Role Summary:

As a Provider Relations Lead, you will lead the provider relations team and play a critical role in developing and maintaining strong partnerships with healthcare providers. Your primary focus will be on fostering collaborative relationships, addressing provider needs and concerns, and ensuring alignment with organizational goals and objectives. In addition to serving as the communications lead for the project.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Team Leadership:  Lead a team of Provider Relations Specialists, including assigning tasks, providing training and development opportunities, and conducting performance evaluations.   

• Relationship Management: Develop and maintain strong, collaborative relationships with healthcare providers, including physicians, hospitals, Tribal Organizations, Presumptive Eligibility Determiners, and clinics. 

• Issue Resolution: Serve as a primary point of contact for escalated provider inquiries, issues, and concerns, ensuring timely and effective resolution.  

• Education and Training: Educate providers on organizational policies, procedures, and services to enhance their understanding and support compliance.  

• Communications: 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.  

• Network Development: Work with internal and external teams to expand and optimize provider networks, ensuring adequate coverage and quality of services through outreach activities.   

• Quality Improvement: Monitor provider performance metrics and collaborate with internal and external team members to identify opportunities for improvement in service delivery and patient outcomes.   

• Compliance Assurance: Ensure providers and provider relations staff adhere to regulatory requirements, contractual obligations, and accreditation standards.  

• Reporting and Analysis: Generate reports, analyze provider data, and present insights to senior management to support strategic decision-making and improve provider relations strategies.  

What you’ll need to succeed:

Qualifications:  

• 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.  

Skills:  

• 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.  

• 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