Remote Provider Credentials Coordinator I

Navitus Health Solutions, LLC; Yorktown (VA); À distance; USD 28 000 - 33 000; Plein temps

Avantages offerts par ce poste

Health, Dental, and Vision insurance

20 days paid time off

4 weeks parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro/M'

Referral Bonus Program – up to $750

Résumé du poste

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The Coordinator will facilitate receipt, processing, first level evaluation, and creation of reports for provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

The role requires ensuring credentialing aligns with Navitus policies and URAC standards. The Coordinator reports to the Manager of Provider Services and supports Pharmacy Relations Contract Analysts to ensure all

Qualifications

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

Responsabilités

• Review and process credentials for pharmacy providers daily.
• Audit credential documentation and ensure compliance.
• Create credential activity reports for leadership and committees.
• Monitor credential databases (NCPDP, HMS, DEA, State Boards).
• Support network development and pricing questions.

Connaissances

Telephonic communication

Written communication

Analytical skills

Independent work

Multitasking

Formation

High school diploma or equivalent

Advanced degree preferred

Outils

Microsoft Office Suite

Data mining

Description du poste

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team. The Coordinator will facilitate receipt, processing, first level evaluation, and creation of reports for provider credentials, working with NCPDP, HMS, DEA, and state/federal databases.

The role requires ensuring credentialing aligns with Navitus policies and URAC standards. The Coordinator reports to the Manager of Provider Services and supports Pharmacy Relations Contract Analysts to ensure all