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Provider Relations Specialist – CCE, Network Support
General Dynamics Information Technology. Serve as primary Provider Services point of contact for assigned Clinical Centers of Excellence (CCEs) .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider relations and healthcare operations, with a strong focus on relationship management, provider enrollment, and operational coordination. Proficient in managing multiple priorities and facilitating effective communication between stakeholders to enhance service delivery.
Highest-signal resume keywords
Provider RelationsHealthcare OperationsProvider EnrollmentRelationship ManagementMicrosoft Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider Lifecycle ProcessesCredentialingContracting/ParticipationClaims ManagementWorkflow ManagementCRM SystemsTicketing SystemsProvider Management Systems
Soft Skills
Communication SkillsProblem-Solving SkillsPresentation SkillsFollow-Through SkillsRelationship Management Skills
Tools & Technologies
JIRAMicrosoft Office Applications
Certifications & Qualifications
MBI (T2) Public Trust Requirement
Industry Keywords
Clinical Centers of ExcellenceHealthcare Program StakeholdersNetwork ManagementOperational ProcessesProvider Services
About the role
Key responsibilities & impact- Serve as primary Provider Services point of contact for assigned Clinical Centers of Excellence (CCEs)
- Develop working relationships and understand each CCE's provider network and operational needs
- Conduct outreach to identify provider concerns, access issues, emerging needs, and service-improvement opportunities
- Support provider nominations and referrals by documenting, researching, tracking, and routing requests
- Coordinate with Provider Network/Contracting staff regarding practitioners, specialists, facilities, and HDOs
- Provide status updates on provider nominations, affiliation, onboarding, and Provider Services activities
- Facilitate communication between CCEs and Provider Services on provider participation and operational issues
- Support providers and HDOs with WTCHP requirements, operational processes, portal use, Terms & Conditions, roster submission, EFT, enrollment, and participation requirements
- Educate providers and CCE stakeholders on WTCHP processes, policies, workflows, and network-participation changes
- Coordinate provider onboarding and orientation activities
- Research and resolve escalated provider issues and systemic concerns
- Partner with Provider Data, Credentialing, Claims, Contracting/Recruitment, and other operational teams
- Identify trends in inquiries, escalations, access concerns, and administrative barriers; elevate findings to leadership
- Maintain documentation in workflow and tracking systems, including JIRA where applicable
- Participate in CCE meetings, operational workgroups, education sessions, and stakeholder forums
- Support reporting on CCE engagement, provider nominations, outstanding issues, network access, and resolution turnaround times
- Promote a high-touch service model supporting uninterrupted access to care for WTCHP members
Requirements
What you’ll need- Bachelor's degree preferred or equivalent combination of education and relevant professional experience
- Three (3) or more years of experience in provider relations, provider services, healthcare operations, health plan operations, network management, or a related healthcare environment
- Experience working directly with provider organizations, hospitals, medical groups, clinical practices, or healthcare program stakeholders strongly preferred
- Working knowledge of provider enrollment, credentialing, provider data, contracting/participation, claims, and provider lifecycle processes
- Strong relationship-management, communication, presentation, problem-solving, and follow-through skills
- Ability to coordinate issues across multiple operational departments while maintaining ownership of the stakeholder experience
- Ability to manage multiple priorities, track open items through resolution, and communicate effectively with internal and external stakeholders
- Proficiency with Microsoft Office applications preferred
- Experience with workflow, CRM, ticketing, or provider management systems preferred
- US citizenship is not required
- MBI (T2) public trust requirement
- Ability to support the New York Metropolitan Area network
- Less than 10% travel
Benefits
Comp & perks- Comprehensive benefits and wellness packages
- 401K with company match
- Competitive pay
- Paid time off
- Medical plan options, some with Health Savings Accounts
- Dental plan options
- Vision plan options
- Full flex work weeks where possible
- Vacation, sick, personal time, holiday, paid parental, military, bereavement, and jury duty leave
- Typically 15 days of paid leave per calendar year
- Additional 10 paid holidays per year
- Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees
- Short- and long-term disability benefits
- Life insurance
- Accidental death and dismemberment insurance
- Personal accident insurance
- Critical illness insurance
- Business travel and accident insurance
- AI-powered career tool identifying career steps and learning opportunities
- Internal mobility team focused on career goals
- Award-winning culture of innovation
- Military-friendly workplace
- Remote work / telecommuting