Provider Enrollment Certification Auditor/Documentation Specialist

Type of Requisition:
Regular

Clearance Level Must Currently Possess:
None

Clearance Level Must Be Able to Obtain:
None

Public Trust/Other Required:
None

Job Family:
Program Delivery and Execution

Job Qualifications:

Skills:
Business Operations Analysis (Inactive), Detail-Oriented, Documentations, Oral Communications, Technical Writing
Certifications:
None
Experience:
2 + years of related experience
US Citizenship Required:
No

Job Description:

Contribute to the strategic direction of the business and support impactful mission outcomes as a Provider Enrollment Certification Auditor/Documentation Specialist. Here, you’ll see the bigger picture on mission initiatives and where your program management career can go at GDIT.

Bring your documentation management, process improvement, and healthcare operations expertise to GDIT. The Documentation Specialist must have:

- Education: BA/BS or equiv.
- Experience: 2+ years of experience in technical writing, process documentation, healthcare operations, credentialing, provider enrollment, quality management, or a related field.
- Technical Skills: Technical and procedural writing Microsoft Word, Excel, PowerPoint, and SharePoint Process mapping and workflow documentation Document version control and records management Data analysis and reporting Attention to detail and quality review
- Role Requirements: Ability to interpret and document complex business processes. Strong organizational and project coordination skills. Excellent written and verbal communication skills. Experience supporting provider enrollment, credentialing, Credentialing Verification Organization (CVO) activities, NC Medicaid, NCQA, CMS, or healthcare regulatory environments preferred. Experience creating and maintaining desktop procedures, enrollment manuals, operational policies, job aids, and training materials. Ability to develop provider profiles and supporting documentation for Credentialing Committee review. Ability to manage multiple priorities and meet established deadlines in a fast-paced operational environment. Demonstrated ability to collaborate with cross-functional teams to support compliance, quality, and operational excellence.
- ### Documentation Management and Governance
Create new and revise existing Desk Procedures (DPs), Policy Interpretations, Operations Manuals, and supporting documentation.
- Analyze business rule changes, policy updates, system enhancements, and operational process changes to determine documentation impacts.
- Review Functional Modification Requests (FMRs) submitted by customers and business stakeholders to identify required documentation updates.
- Collaborate with operational teams, business owners, leadership, and subject matter experts to gather information necessary for document development.
- Ensure all documentation is clear, concise, standardized, and follows established formatting and version control requirements.
- Maintain document inventories and repositories to ensure the most current versions are accessible to staff.
- Conduct routine audits of existing documentation to identify outdated processes, conflicting instructions, or areas requiring clarification.
- Track document revisions and maintain records of updates, approvals, and implementation dates.

- ### Policy and Regulatory Review
Review policy changes and regulatory requirements to assess operational impact.
- Meet with leadership to discuss proposed policy updates and required procedural modifications.
- Translate complex policy language into operational procedures and staff guidance.
- Ensure all documentation remains aligned with NC DHHS, NCQA, and organizational requirements.
- Provide recommendations for operational process improvements based on policy and regulatory changes.

- ### Department Subject Matter Expert (SME)
Serve as the primary departmental resource for locating and interpreting business rules, operational requirements, and procedural guidance documented within Desk Procedures and Operations Manuals.
- Respond to staff and leadership inquiries regarding documented processes and operational requirements.
- Provide guidance and clarification regarding procedure interpretation and policy application.
- Assist departments with identifying existing documentation before creating new processes.

- ### Provider Profile Development and Review
Create provider profiles for credentialing committee review.
- Review provider files and supporting documentation to ensure profile accuracy, completeness, and compliance with credentialing requirements.
- Analyze credentialing information and summarize findings for committee consideration.
- Perform quality reviews of provider profiles prior to committee presentation.
- Redact confidential, protected, or sensitive information in accordance with organizational policies and privacy requirements.
- Ensure provider profiles accurately reflect credentialing findings and required committee actions.

- ### Credentialing Meeting Support
Participate in daily provider profile review meetings with credentialing staff and leadership.
- Present provider profile content and address questions during review sessions.
- Collaborate with credentialing leadership to resolve profile discrepancies and documentation concerns.
- Prepare provider profiles for final presentation to the Credentialing Committee.
- Attend weekly Credentialing Committee meetings to provide documentation support and answer questions related to provider profiles, credentialing findings, and committee recommendations.
- Document committee feedback requiring profile updates or process improvements.

- ### Credentialing Committee Coordinator Backup Responsibilities
Serve as backup to the Credentialing Committee Coordinator as needed.
- Assist with meeting preparation, agenda compilation, and committee materials.
- Support meeting scheduling and participant communications.
- Coordinate committee documentation, reports, and meeting packets.
- Assist with meeting minute preparation and distribution.
- Ensure committee records are maintained according to organizational and regulatory requirements.

- ### Quality, Compliance, and Accreditation Support
Support NCQA, CVO, and organizational quality initiatives.
- Update documentation to reflect accreditation standards, audit findings, corrective actions, and process improvements.
- Assist with preparation for accreditation surveys, audits, and compliance reviews.
- Participate in process improvement projects that impact departmental procedures and workflows.
- Collaborate with quality management and operational leadership to implement documentation-related corrective actions.

- ### Cross-Functional Collaboration
Partner with Operations, Credentialing, Compliance, Quality, Information Technology, and Leadership teams to ensure documentation reflects current business practices.
- Participate in departmental meetings, workgroups, and project discussions related to operational changes.
- Support implementation activities by communicating documentation changes and providing education to impacted staff.
- Assist with training initiatives by developing procedural guidance and reference materials.

- ### Continuous Improvement
Identify opportunities to improve document management processes and operational efficiency.
- Recommend enhancements to documentation standards, templates, and governance practices.
- Monitor trends, recurring questions, and audit findings to identify areas requiring additional documentation or clarification.
- Support strategic initiatives involving process redesign, system implementations, and workflow optimization.

- ## Key Deliverables
Desk Procedures (DPs)
- Policy Interpretations
- Operations Manuals
- FMR Documentation Updates
- Provider Profiles
- Credentialing Committee Materials
- NCQA/CVO Documentation Updates
- Process Flow Documentation
- Training and Reference Materials

- GDIT IS YOUR PLACE
At GDIT, the mission is our purpose, and our people are at the center of everything we do.
● Growth: AI-powered career tool that identifies career steps and learning opportunities
● Support: An internal mobility team focused on helping you achieve your career goals
● Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off
● Flexibility: Full-flex work week to own your priorities at work and at home.
● Community: Award-winning culture of innovation and a military-friendly workplace

OWN YOUR OPPORTUNITY
Explore a career at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your ambition to deliver your best work.

The likely salary range for this position is $55,806 - $71,300. 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.

Scheduled Weekly Hours:
40

Travel Required:
None

T elecommuting Options:
Hybrid

Work Location:
Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and 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. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as 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. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

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.

Join our Talent Community to stay up to date on our career opportunities and events at
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Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans