Remote Pharmacy Provider Credentialing Coordinator

Navitus; Lincoln (NE); Remote; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health, dental, vision insurance

Paid time off

Parental leave

Holidays

401K match

Adoption assistance

Flexible Spending Account

Educational assistance

Professional membership

Referral bonus

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. This role focuses on credentialing providers, data management, and supporting compliance with URAC standards across national databases.

The position requires strong communication, accuracy, and the ability to work independently while coordinating with multiple departments and external providers. Remote-friendly with a robust benefits package.

Qualifications

• High school or equivalent; advanced degree preferred.
• Retail pharmacy or managed care pharmacy experience desired.
• Experience analyzing medical/pharmacy claims or credentials is highly desired.
• Ability to work independently with strong written and telephonic communication skills.
• Proficiency with Microsoft applications and ability to interact with providers at all levels.

Responsibilities

• Daily communication with Navitus pharmacy providers and vendors to obtain, review, and process credentials.
• Ensure credentials are received and documented in systems; audit files for non-compliance.
• Support URAC compliance and Navitus policies; update procedures as statutes or guidance change.
• Create reports on credential activity and present to VP and Committees.
• Monitor credential databases (HMS, NCPDP, OIG, DEA, State Boards) for data integrity.
• Assist in administration of Navitus pharmacy programs and resolve provider pricing questions.
• Help obtain annual Fraud, Waste, and Abuse attestations from providers.

Skills

Independent work

Telephonic & written communication

Data mining in databases

Analytical skills

Multi-priority management

Provider interaction skills

Education

High School or equivalent

Advanced degree preferred

Tools

Microsoft applications

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. This role focuses on credentialing providers, data management, and supporting compliance with URAC standards across national databases.

The position requires strong communication, accuracy, and the ability to work independently while coordinating with multiple departments and external providers. Remote-friendly with a robust benefits package.