Provider Credentials Coordinator - Compliance & Network

Navitus; Carson City (NV); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health, Dental, Vision insurance

Paid time off (20 days)

Parental leave (4 weeks)

Paid holidays (9)

401K company match

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team in Nevada. This role handles intake, processing, first level evaluation, and reporting of provider credentials, aligning with URAC standards and Navitus policies.

You will work with NCPDP, HMS, DEA, and state/federal databases, maintain credential files, and support compliance through documentation, reporting, and annual attestations. Strong communication and data-management skills are essential.

Qualifications

• High school diploma or equivalent; advanced degree preferred.
• Experience in retail or managed care pharmacy is a plus.
• Experience analyzing medical/pharmacy claims or credentials is highly desired.

Responsibilities

• Process and review provider credentials and create reports.
• Maintain credential records in systems; audit for compliance.
• Support URAC and Navitus policies; update procedures as statutes change.
• Extract and monitor credential data from HMS, NCPDP, OIG, DEA and boards.
• Collaborate with network teams on credentialing workflows and attestations.

Skills

Communication skills

Data mining

Analytical skills

Multi-tasking

Microsoft Office

Education

High school diploma or equivalent

Tools

NCPDP databases

HMS databases

DEA / regulatory databases

Microsoft Office Suite

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team in Nevada. This role handles intake, processing, first level evaluation, and reporting of provider credentials, aligning with URAC standards and Navitus policies.

You will work with NCPDP, HMS, DEA, and state/federal databases, maintain credential files, and support compliance through documentation, reporting, and annual attestations. Strong communication and data-management skills are essential.