Provider Relations Representative

GDIT is seeking a Provider Relations Representative to serve as the frontline liaison between the World Trade Center Health Program (WTCHP) and participating healthcare delivery organizations.

About the role

The Provider Relations Representative is responsible for provider onboarding, education, issue resolution, relationship management, provider engagement and satisfaction, and coordination of operational support activities. The role partners with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT to deliver consistent, high-quality provider experience and ensure operational excellence.

Key Outcomes & Success Metrics

• Achieve targeted provider satisfaction scores and first-contact resolution rates; reduce escalations and repeat issues.
• Meet or exceed SLAs for onboarding and participation activation; shorten cycle times and eliminate avoidable delays.
• Decrease average issue aging and backlog across claims, credentialing, enrollment, provider data, contracts, and portal support.
• Increase portal registration, use of self-service features, EFT enrollment, and training attendance.
• Improve responsiveness and clarity of provider communications, job aids, and training materials.
• Maintain audit-ready documentation; sustain SLA compliance and quality scores.

Responsibilities

• Relationship Management & Account Ownership
  • Serve as the primary point of contact for assigned providers; conduct regular touchpoints and executive-level check-ins/QBRs as needed.
  • Track provider sentiment and satisfaction; identify themes and drive action plans with the Provider Network Supervisor.
  • Document all interactions, decisions, and follow-ups in CRM/case management tools with clear, accurate notes.
• Onboarding & Orientation
  • Coordinate end-to-end onboarding: welcome materials, portal registration, EFT setup, credentialing handoffs, and directory validation.
  • Standardize checklists, timelines, and handoffs with Credentialing, Provider Data, and Contracting to ensure accurate participation activation.
  • Monitor onboarding milestones and proactively remove blockers; communicate status and next steps to providers.
• Education, Training & Communications
  • Deliver provider training (webinars, welcome packets, job aids) on program policies, billing requirements, and operational procedures.
  • Tailor content to provider segments and roles; measure adoption and comprehension via attendance, feedback, and follow-up assessments.
  • Maintain a current library of FAQs, guides, and reference materials aligned to process changes.
• Issue Intake, Escalation & Resolution
  • Resolve escalated provider issues related to claims, credentialing, EFT, enrollment, and portal access; triage and route effectively.
  • Follow defined escalation pathways; communicate resolution status, root cause, and prevention actions to providers and internal teams.
  • Perform root-cause analysis for recurring issues and propose corrective actions; track remediation to closure.
• Portal, EFT & Self-Service Enablement
  • Promote portal features and self-service workflows; assist with registration, user management, navigation, and troubleshooting.
  • Increase EFT adoption and ensure accurate banking/EFT data in coordination with Provider Data and Claims; support verification and updates.
• Cross-Functional Collaboration
  • Partner with Provider Data, Credentialing, Contracting, Claims, Finance, Clinical Operations, Communications, and IT to resolve issues and improve processes.
  • Represent provider needs in workgroups; drive action items to completion and report measurable outcomes.
• Reporting, Analytics & Continuous Improvement
  • Maintain dashboards/logs for satisfaction, first-contact resolution, onboarding timeliness, case aging, portal adoption, and SLA compliance.
  • Analyze trends to prioritize outreach, training topics, and process enhancements; share insights in huddles and business reviews.
  • Contribute to continuous improvement initiatives (templates, scripts, automation) to reduce cycle time and error rates.
• Compliance, Policy & Documentation Standards
  • Ensure adherence to organizational policies and applicable regulations; maintain audit-ready documentation and records.
  • Safeguard provider information (privacy/security); support audits and corrective action plans.

Requirements

• 3+ years of related experience in business operations, data ingestion, problem solving, or reporting management.
• US citizenship is not required.

Pay

The likely salary range for this position is $46,301 - $62,100. Salary will be set based on experience, geographic location, and possibly contractual requirements.

Schedule

• Scheduled weekly hours: 40
• Travel required: Less than 10%
• Telecommuting options: Remote (any location in the US)

Benefits

• Health & Wellness
  • Medical plan options, some with Health Savings Accounts.
  • Dental and vision plan options.
• Retirement
  • 401(k) plan with pre- and post-tax contribution options up to IRS annual limits and company match.
• Paid Time Off
  • 15 days of paid leave per calendar year for vacations, personal business, and illness (prorated based on hire date).
  • 10 paid holidays per year (prorated based on hire date).
  • Paid parental, military, bereavement, and jury duty leave.
  • Paid Family Leave program: up to 160 hours of paid leave in a rolling 12-month period for eligible employees.
• Income Protection
  • Short- and long-term disability benefits.
  • Life, accidental death and dismemberment, personal accident, critical illness, and business travel and accident insurance.
• Work-Life Balance
  • Flexible work weeks where possible.