Home
/
Comprehensive
/
Coordinator Provider Credentials Remote
Coordinator Provider Credentials Remote-July 2024
Appleton
Jul 18, 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
Food Service Director 26956
This is a job for a Food Service Director position with a company located in the Natchez, MS area. About This Position: The Food Service Director plans, directs and coordinates the activities associa
Part-time Afternoon Receptionist
WANE 15 is seeking a Front Desk Receptionist to manage our front desk daily and to perform a variety of administrative and clerical tasks. This will be a part-time position working in the afternoons
Global BCP Program Manager
The Global Business Continuity Program Manager is a member of the Global Workplace Experience Team (WPE). As Champions for the Future Way of Work, WPE is committed to creating an exceptional work exp
Pharma Drug Product Technical Services
Job Description The scope of the current open position includes (a) Drug Product technical investigations, solution development & implementation; (b) technical change management and (c) proactive
Group Manager
26520BR Service Line: Environmental Office Name: Phoenix Job Description: Are you passionate about the environment and want to make a difference in the world? Terracon, a 100% employee-owned company,
Assembly Technician I
This position works among a team of individuals manufacturing Photonics products for our customers with the assistance of experienced team members. The role entails such functions as kitting, assembl
Retail Sales Associate
141002BRPosting Title:Retail Sales AssociateJob Description: A Retail Sales Associate (part-time) is a valued member of a high performing team who is empowered & equipped to do their job. You wil
WAITER/WAITRESS (FULL TIME AND PART TIME)
Unidine Unidine is hiring immediately for full time and part time WAITER/WAITRESS positions. Location: University Place - 1700 Lindberg Road, West Lafayette, IN 47906 Schedule: Full time and part tim
Full-time Entry Level Roles - 2024 Graduates
“We’re not in the shipping business; we’re in the information business” -Peter Rose, Expeditors Founder As a Fortune 500 company, Expeditors employs more than 17,000 trained professionals in a worldw
Retail Associate
Our values start with our people, join a team that values you! We are the nation’s largest off-price retailer with over 2,000 stores, and a strong track record of success and growth. Our focus has al
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved