LPN

Remote

6 month contract

$25 - $27.87 an hour

Position Summary

We are seeking experienced LPN/LVN candidates with prior authorization experience in a specialty medical office (MDO), PBM, or clinical setting.

This role requires the ability to work in a high-volume, metrics-driven environment while maintaining strong clinical judgment, accuracy, and efficiency.

Successful candidates are self-directed, resourceful, and adaptable, with the ability to quickly interpret clinical information, navigate multiple systems simultaneously, and maintain productivity while managing competing priorities.

This is a fully remote role requiring a high level of accountability, focus, and independence throughout the entire shift.

Permanent Schedule

Schedules are assigned based on business needs and may include:

Sunday-Thursday or Tuesday-Saturday

Shifts between 10:00 AM-6:30 PM CST

Schedule flexibility, overtime, and weekend availability are required.

Key Responsibilities

Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations

Review and process complex prior authorization requests using clinical criteria and supporting documentation

Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy

Review chart notes, claims history, and prior authorization history to make accurate determinations

Submit complete and accurate documentation to support determinations and avoid unnecessary delays

Identify cases requiring escalation and refer appropriately

Demonstrate critical thinking and problem-solving when information is unclear or incomplete

Apply internal workflows, job aids, and policies correctly and consistently

Adapt quickly to changing priorities, processes, and clinical criteria

Communicate clearly and professionally with team members, pharmacists, providers, and leadership

Ask questions and seek clarification when needed to ensure accuracy

Maintain attention to detail while processing high volumes of work efficiently

Participate in quality assurance activities and apply feedback for continuous improvement

Perform work in a sedentary, desk-based environment requiring prolonged sitting, typing, and screen time

Maintain consistent attendance, productivity, and adherence to scheduled work hours

Required Qualifications

Active, unrestricted LPN/LVN license

Minimum 2+ years of recent prior authorization experience in a PBM, MDO, or clinical setting

Experience reviewing and applying clinical criteria and supporting documentation for prior authorizations

Experience using CoverMyMeds or similar authorization platforms

Familiarity with chart notes, claims history, and insurance requirements

Technical Skills

Strong computer proficiency across multiple systems:

Outlook

Teams

Word

Excel

Other healthcare systems

Ability to multitask across multiple monitors and applications simultaneously

Advanced keyboarding skills with the ability to type quickly and accurately

Behavioral and Work Style Requirements

Proven ability to work in a fast-paced, high-production, metrics-driven environment

Strong attention to detail while maintaining speed and accuracy

Ability to learn quickly and work independently with limited guidance

Strong time management and organizational skills in a remote setting

Ability to remain focused and productive while working independently for full shifts

Comfortable working in a structured, highly monitored environment with performance metrics

Strong written and verbal communication skills, including the ability to clearly articulate clinical information and medication names

Ability to receive, apply, and act on real-time feedback

Preferred Qualifications

3+ years of prior authorization experience

Experience in a specialty medical office or with specialty medications

Broad clinical background across multiple disease states

Previous call center or high-volume clinical processing experience

What Makes Someone Successful in This Role

Successful team members consistently demonstrate:

Ability to work under pressure while maintaining accuracy and productivity

Ownership, reliability, and accountability for performance

Resourcefulness and ability to locate and interpret information independently before escalating

Confidence to ask questions, seek clarification, and speak up when unsure

Ability to quickly learn new medications, disease states, and clinical criteria

Strong multitasking ability across systems, workflows, and communication tools

Excellent attention to detail combined with processing speed

Resilience and adaptability when adjusting to frequent changes and challenges

Ability to remain focused and productive despite obstacles, system issues, or changing priorities

Ability to work successfully within a structured, performance-driven environment

Strong self-awareness and coachability, including the ability to accept and apply feedback

Accountability for personal performance, learning, and development

Ability to work independently in a distraction-free remote environment

Work Environment & Expectations

Fully remote position requiring a quiet, dedicated, distraction-free workspace

Extended periods of desk-based work, including:

Screen time

Keyboarding

Phone use

Continuous performance tracking includes:

Productivity

Quality

Adherence

Additional expectations:

Comfortable working in a highly structured, closely monitored environment

Ability to troubleshoot minor technical issues independently, partner with IT as needed, and maintain accountability for timely follow-up and resolution

Education

The Licensed Practical Nurse must be a graduate of a school of Practical or Vocational Nursing approved by the State Agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed.

The LPN/LVN must have a full, active, and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory, Commonwealth of the United States, or District of Columbia.

Registered Nurses (RNs) are not accepted for LVN/LPN roles unless otherwise stated.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.


Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).


This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.