Home
/
Comprehensive
/
Coordinator Provider Credentials Remote
Coordinator Provider Credentials Remote-July 2024
Appleton
Jul 11, 2025
About Coordinator Provider Credentials Remote

  JOB REQUIREMENTS: Putting People First in Pharmacy- Navitus was foundedas an alternative to traditional pharmacy benefit manager (PBM) models.We are committed to removing cost from the drug supply chain to makemedications more affordable for the people who need them. At Navitus,our team members work in an environment that celebrates diversity,fosters creativity and encourages growth. We welcome new ideas and sharea passion for excellent service to our customers and each other. Due togrowth, we are adding Provider Credentials Coordinator to our ProviderServices department. We are unable to offer remote work to residents ofAlaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, NorthDakota, Rhode Island, South Carolina, South Dakota, West Virginia, andWyoming. The Coordinator I, Provider Credentials is responsible forfacilitating the receipt, processing, first level evaluation, andcreation of Internal and external reports of provider credentials. TheCoordinator I, Provider Credentials will work extensively with NCPDP,HMS, DEA, States\' provider databases, and Federal databases. Theindividual(s) in this position will report to the Manager of ProviderServices and support Pharmacy Relations Contract Analyst(s) to ensurethat all pharmacy providers are appropriately credentialed according tofederal and state regulations and statutes. The Coordinator I, ProviderCredentials is also accountable for ensuring the pharmacy credentialingprocess meets Navitus\' policies, complies with URAC standards, andensures that Navitus does not allow non-qualified pharmacies toparticipate and non-qualified prescribers to process claims. The role ofthe Coordinator I, Provider Credentials requires knowledge of pharmacyprocessing practices, pharmacy laws and regulations, and verbal andwritten communication skills. Is this you? Find out more below! How do Imake an impact on my team? Daily communication with Navitus pharmacyproviders, including Navitus\' strategic vendor(s), to obtain, review,and process credentials. Ensures that pharmacy credentials are received,documented in appropriate systems, and retained in pharmacy contractfiles. Audits files or systems to identify non-compliant documentation.Supports compliance to URAC and Navitus\' policy and procedures toensure a quality credentialed pharmacy network. Ability to enrich P&Psto meet new or updated statutes, laws, regulations, or guidance. Createreports of credential activity, including positive credentials, negativecredentials, issues associated with credentials, etc. Reports submittedto department VP and to Credential Committees. Monitors and extractsinformation from credential databases, such as HMS, NCPDP, OIG, DEA,State Boards of Pharmacy, and others as identified. Support PharmacyNetwork personnel in administration... For full info follow applicationlink. Navitus Health Solutions is an Equal Opportunity Employer:Disabled/Veterans/Male/Female/Minority/Other ***** APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/ECBB62056C304C24

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Powder Coating Paint Line Operator
Powder Coating Paint Line Operator - 2 fulltime, temporary, peak load (H-2B) jobs available 4/1/24-12/15/24. Employer: Optimum Window Mfg. Corp, 28 Canal St, Ellenville, NY 12428. Duties: Responsible
Data Analyst
This job was posted by https://illinoisjoblink.illinois.gov : For moreinformation, please see:https://illinoisjoblink.illinois.gov/jobs/11599847 Position Title: Data Analyst Department: Sales FLSA St
HSE Senior Project Engineer - Hybrid
Date Posted: 2024-01-16 Country: United States of America Location: PW100: East Hartford 400 Main Street, East Hartford, CT, 06118 USA Position Role Type: Hybrid Pratt & Whitney is working to onc
Civil Engineer
Summary This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD Workforce to recruit and appoint qualified candidates to positions in the competitive ser
SAP Basis Administrator
Job Title: SAP Basis Administrator Job Description Concentrix Catalyst is the experience design and engineering team of Concentrix, a leading global solutions company that reimagines everything CX th
PMO Business System Analyst Lead
Job Summary This position has a hybrid employment status. While the role will be mostly remote, there will be on-site work at the Corewell Health Place building in Grand Rapids about once a month. Ba
Snowmaker
Create Your Experience of a Lifetime! Come work and play in the mountains! Whether it’s your first-time seeing snow or you were born on the slopes, joining our team means discovering (or re-discoveri
Environmental Technician
Description: The Customer Service Technician will be primarily responsible for repairing/calibrating environmental equipment and developing relationships with customers. 60% of work will be technical
Enterprise Architect
Looking to work at a firm with an unbeatable culture? Withum is a forward-thinking, technology-driven advisory and accounting firm, helping clients to Be in a Position of StrengthSM in today's modern
Career Opening. Psychologist Position Available!
$70-75 The School Psychologist works to support students through a variety of mental health and developmental issues and aid in qualifying students for additional support services. The School Psychol
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved