Remote Pharmacy Provider Credentialing Coordinator

Navitus Health Solutions, LLC; Accident (MD); Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health, dental & vision insurance

20 days paid time off

Parental leave (4 weeks)

9 paid holidays

401K company match up to 5%

Adoption assistance

Flexible Spending Account

Educational assistance & professional支

Referral bonus program

Job summary

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, and first-level evaluation of provider credentials, ensuring compliance with federal and state regulations and Navitus policies.

You will work with NCPDP, HMS, DEA, and state/federal databases. You will report to the Manager of Provider Services and support Pharmacy Relations Contract Analysts to credential providers and maintain a qualified

Qualifications

• High school diploma required; advanced degree preferred.
• Experience in retail pharmacy or managed care setting preferred.
• Experience analyzing medical/pharmacy claims or credentials.
• Ability to work independently with strong communication and data skills.

Responsibilities

• Daily communication with Navitus providers to obtain and review credentials.
• Ensure credentials are documented and audited for compliance.
• Support URAC compliance and update policies as needed.
• Create credential activity reports for leadership (VP and Committees).
• Monitor credential databases (NCPDP, HMS, DEA, State Boards).
• Assist in credential program development and vendor coordination.
• Other duties as assigned.

Skills

Independent work

Telephone communication

Data mining

Analytical skills

Microsoft Office

Multitasking

Education

High school or equivalent

Tools

NCPDP

HMS

DEA databases

State Boards of Pharmacy

Job description

Navitus Health Solutions, LLC is seeking a Coordinator I, Provider Credentials to join our team. The role focuses on facilitating receipt, processing, and first-level evaluation of provider credentials, ensuring compliance with federal and state regulations and Navitus policies.

You will work with NCPDP, HMS, DEA, and state/federal databases. You will report to the Manager of Provider Services and support Pharmacy Relations Contract Analysts to credential providers and maintain a qualified