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Added 9 mins ago
Partner Manager – MedSpa
Jobgether
Remote, United States
We are looking for a commercially minded partnership professional to help expand a leading SaaS platform’s presence in the North American medical aesthetics market. In this fully remote…
Added 27 mins ago
JE
J Resort - Director of Food & Beverage
JACOBS ENTERTAINMENT INC.
Reno, NV
- $89,346 to $122,850 USD / year
Our employees are supported with a comprehensive benefits program that include the following:
Added 40 mins ago
Program Director - TS/SCI
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Remote, United States
The Program Director will lead Parsons’ business development, customer engagement, opportunity shaping, and future program execution activities in the Philippines. This will be a US based…
Added 52 mins ago
Quality Manager - Nondestructive Test (NDT)
The Boeing Company
Mesa, AZ
Candidates must have at least one year of experience in a leadership role (team leader, temp manager, large scale cross-functional project/program management, or formal manager experience)…
Added 53 mins ago
District Sales Manager - UPLIZNA- IgG4 - Rare Disease - Phoenix, AZ
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Phoenix, AZ
We are all different, yet we all use our unique contributions to serve patients. The District Sales Manager – IgG4-RD professional we seek is a motivated professional with these…
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Account Manager / Specialty Account Manager - IgG4 (Rare Disease) - Phoenix, AZ
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HP
Document Control & Training Coordinator - PB
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- $19.5 to $22.5 USD / hour
· Participates in the design, development, and maintenance of Quality Management System documentation.
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Senior Systems Administrator (College Support)
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The Senior Systems Administrator will join a program providing User-facing and Data Center Services supporting an Intelligence Community customer. All the personnel on the team will work…
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Guest Services Supervisor (Full Time)
AccorHotel
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- $32.09 USD / hour
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Senior Seed Sales Grower Relationship Specialist
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Senior Manager, Forward Deployed Engineering – Tax & Audit
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Brooklyn, NY · NY · Ann Arbor, MI · Frisco, TX · Chicago, IL · Eagan, MN
Build, lead and develop a senior engineering team of engagement leads, AI engineers and integration engineers, owning hiring, coaching, performance management and career development.
Added 2 hours ago
Program Manager
GCyber
Scott Air Force Base, IL
GCyber is committed to the well-being and development of every employee. Our benefits are designed to support your personal and professional goals, from health and wellness programs to…
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Added 2 hours ago
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Sr Project Manager
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Marketing Creative Manager
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Program Services Manager - Vizient Reserve (Healthcare)
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…dedication directly influence success. This role provides rewarding professional development and advancement opportunities in a dynamic and supportive environment. Loan Sales Specialists…

Navitus Health Services

Coordinator, Provider Credentials

Helena, MT, United States

$20.19 to $23.75 USD / hour

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Job details

Pay: $20.19 to $23.75 USD / hour
Posting language: English
Posted: Oct 30, 2026

Original job description

Compensation

$20.19 - $23.75 / hourly

Hours Per Week

Number Of Positions

Job Description

Overview

Navitus Health Solutions is seeking a Coordinator I, Provider Credentials to join our team!

The Coordinator I, Provider Credentials is responsible for facilitating the receipt, processing, first level evaluation, and creation of Internal and external reports of provider credentials. The Coordinator I, Provider Credentials will work extensively with NCPDP, HMS, DEA, States’ provider databases, and Federal databases. The individual(s) in this position will report to the Manager of Provider Services and support Pharmacy Relations Contract Analyst(s) to ensure that all pharmacy providers are appropriately credentialed according to federal and state regulations and statutes. The Coordinator I, Provider Credentials is also accountable for ensuring the pharmacy credentialing process meets Navitus’ policies, complies with URAC standards, and ensures that Navitus does not allow non-qualified pharmacies to participate and non-qualified prescribers to process claims. The role of the Coordinator I, Provider Credentials requires knowledge of pharmacy processing practices, pharmacy laws and regulations, and verbal and written communication skills.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

Daily communication with Navitus pharmacy providers, 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 contract files. Audits files or systems to identify non-compliant documentation
Supports compliance to URAC and Navitus’ policy and procedures to ensure a quality credentialed pharmacy network. Ability to enrich P&Ps to meet new or updated statutes, laws, regulations, or guidance
Create reports of credential activity, including positive credentials, negative credentials, issues associated with credentials, etc. Reports submitted to department VP and to Credential Committees
Monitors and extracts information from credential databases, such as HMS, NCPDP, OIG, DEA, State Boards of Pharmacy, and others as identified
Support Pharmacy Network personnel in administration of the Navitus pharmacy programs with providers, resolution of pharmacy contractual pricing questions or issues, communication of processing requirements to providers and general resolution of processing issues
Supports obtaining and reporting of annual Fraud, Waste, and Abuse attestations from providers. Supports obtaining other attestations as required supporting Navitus business practices
Updates systems to reflect data consistent with external databases, such as NCPDP, as appropriate
Assists VP and other Network Development associates in the determination, review, and implementation of pharmacy network strategies
Other duties as assigned

Qualifications

What our team expects from you?

High school or equivalent, advanced degree preferred
Retail pharmacy experience or experience in a managed care pharmacy setting desired
Prior experience analyzing medical and/or pharmacy claims or credentials highly desired
Ideal candidate will be able to work independently, have telephonic and written communication skills, data-mine variable databases, analytical skills and can manage multiple priorities
Ability to professionally interact with providers at all levels (both internal and external) is required
Must be able to function independently, however work closely with individuals within other departments
Candidate must be proficient in Microsoft applications
Candidate must rely on knowledge of Navitus’ business concepts, practices, and policies and procedures to accomplish goals
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Navitus?

Top of the industry benefits for Health, Dental, and Vision insurance
20 days paid time off
4 weeks paid parental leave
9 paid holidays
401K company match of up to 5% - No vesting requirement
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance
Referral Bonus Program – up to $750!

Navitus Health Solutions is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other characteristic protected by law.

Apply Here: https://www.click2apply.net/qynQaau4AbYyOImg4tM7Yd

PI288057401

Is this a registered apprenticeship?

False

Place of Work

On-site

Requisition ID

Job Type

Full Time

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