Managed Care Organization

How to Get Credentialed with WellCare (Centene) in New Jersey

Network: Open
CAQH Required

Quick Overview

Timeline

Varies

CAQH

Required

Re-credentialing

Every 3 year(s)

Delegated

No

New Jersey-Specific Requirements

WellCare of New Jersey participates in the NJ FamilyCare Medicaid managed care program. Providers must first enroll with NJ Medicaid through the NJMMIS portal, then apply to WellCare via CAQH ProView. Active New Jersey medical license and NPI are required. Service areas cover all 21 New Jersey counties. The plan serves children, pregnant women, parents, and adults under the NJ FamilyCare umbrella.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for New Jersey.

2

Complete Your CAQH ProView Profile

WellCare (Centene) requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.

3

Submit Your Application

Submit your completed enrollment package to WellCare (Centene).

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Board Certification

Conditional

Required if board certified; highly recommended

CV/Resume

DEA License

Conditional

Required if prescribing controlled substances

Malpractice Insurance

Medical Degree

Medical License

NPI Certificate

Professional Reference

Contact Information

Credentialing

National

Network Enrollment

National

Quick Links

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