Remote Provider Credentialing Coordinator

Navitus Health Solutions, LLC; Iowa Center (IA); Remote; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Prof.

Referral Bonus Program – up to $750

Job summary

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. This role manages the receipt, processing, first-level evaluation, and reporting of provider credentials, coordinating with NCPDP, HMS, DEA, and state/federal databases.

You will ensure credentialing meets URAC standards and Navitus policies while supporting providers and internal teams. The position emphasizes independent work, strong communication, data-mining, and attention to regulatory detail, with a

Qualifications

• High school degree or equivalent; advanced degree preferred.
• Retail pharmacy or managed care pharmacy experience desired.
• Experience analyzing medical/pharmacy claims or credentials preferred.
• Must work independently with telephonic and written communication skills; capable of data mining and multitasking.
• Ability to interact professionally with providers at all levels.
• Proficient in Microsoft applications and Navitus policies.

Responsibilities

• Daily communication with Navitus pharmacy providers and vendors to obtain, review, and process credentials.
• Ensure credentials are documented in systems and audit for non-compliance.
• Support URAC compliance and update procedures to meet statutes and guidance.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (NCPDP, HMS, DEA, State Boards) and extract data.
• Assist in administering pharmacy network programs and resolve pricing questions.
• Support annual Fraud, Waste, and Abuse attestations and other required attestations.
• Update systems to reflect data from external databases.
• Assist leadership in determining network strategies; perform other duties as assigned.

Skills

Independent work

Telephonic communication

Written communication

Data mining

Analytical skills

Provider relations

Multi-priority management

Education

High school or equivalent

Advanced degree preferred

Tools

Microsoft Office

Job description

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. This role manages the receipt, processing, first-level evaluation, and reporting of provider credentials, coordinating with NCPDP, HMS, DEA, and state/federal databases.

You will ensure credentialing meets URAC standards and Navitus policies while supporting providers and internal teams. The position emphasizes independent work, strong communication, data-mining, and attention to regulatory detail, with a