LPN/LVN Prior Authorization Specialist

To support the processing of specialty medication Prior Authorization requests, the full-time LPN/LVN Prior Authorization Specialist will work remotely, managing inbound calls, processing cases, and maintaining documentation while collaborating with healthcare professionals and members. Key responsibilities Process and communicate specialty medication Prior Authorization requests, including managing inbound calls and electronic authorizations Maintain complete and accurate documentation through data entry and reporting, ensuring compliance with established policies Review criteria-based Prior Authorizations and refer cases that do not meet clinical criteria to the appropriate medical team Required qualifications Active and unrestricted LPN/LVN license High School Diploma or equivalent Minimum of 1 year of clinical nursing experience Experience in Prior Authorization processing and review Demonstrated ability to work in a HIPAA-compliant remote environment