Remote Credentialing Operations Lead

General Dynamics Information Technology; Falls Church (VA); On-site; USD 53,000 - 62,000; Full time

Job summary

General Dynamics Information Technology is seeking a Provider Credentialing Specialist Lead to serve as the operational SME responsible for designing, implementing, and maintaining credentialing workflows for government programs. The role partners with government stakeholders, business teams, and technical resources to translate requirements into scalable processes and ensure regulatory compliance.

The position oversees credentialing operations, PSV, committee preparation, workflow

Qualifications

• 3+ years of related experience.

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.

Skills

Documentation Review

Document Reporting (Inactive)

Operational Requirements

Standard Operating Procedure (SOP)

Job description

General Dynamics Information Technology is seeking a Provider Credentialing Specialist Lead to serve as the operational SME responsible for designing, implementing, and maintaining credentialing workflows for government programs. The role partners with government stakeholders, business teams, and technical resources to translate requirements into scalable processes and ensure regulatory compliance.

The position oversees credentialing operations, PSV, committee preparation, workflow