Provider Credentialing Supervisor

Clearance Level

None

REQ#: RQ226066

Public Trust: MBI (T2)

Requisition Type: Regular

Your Impact

Own your opportunity to be on the frontlines of health innovation. Deliver for America’s health agency missions and enhance lives for hundreds of millions every day.

Job Description

Provider Credentialing Specialist Lead

Position Summary

The Provider Credentialing Specialist serves as the operational subject matter expert (SME) supporting the design, implementation, and ongoing development of a government healthcare credentialing program. This role partners with government stakeholders, business teams, and technical resources to translate operational requirements into scalable credentialing workflows while ensuring compliance with CMS, NCQA, organizational policies, and regulatory requirements.

The position is responsible for implementation activities, provider credentialing operations, primary source verification (PSV), committee preparation, workflow documentation, and serving as the primary operational contact for government clients regarding credentialing processes.

Essential Responsibilities

Serve as the primary operational contact for government stakeholders regarding credentialing operations.
Support implementation activities for new credentialing processes and system enhancements.
Document business requirements and translate operational workflows for technical teams.
Perform initial credentialing and recredentialing activities.
Complete Primary Source Verification (PSV) for all required credentialing elements.
Review provider applications for completeness and compliance.
Prepare credentialing files for committee review.
Ensure credentialing files meet organizational, CMS, and NCQA standards.
Develop and maintain standard operating procedures (SOPs).
Participate in workflow design and process improvement initiatives.
Assist with User Acceptance Testing (UAT) during system implementations.
Identify workflow gaps and recommend operational improvements.
Collaborate with cross-functional teams including IT, compliance, operations, and government stakeholders.
Maintain credentialing documentation and audit readiness.
Monitor credentialing timelines and ensure compliance with established turnaround times.

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Work Requirements

Years of Experience

3 + years of related experience

* may vary based on technical training, certification(s), or degree

Certification

Travel Required

Less than 10%

Salary and Benefit Information

The likely salary range for this position is $53,310 - $61,525. 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.
View information about benefits and our total rewards program.

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.

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Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans