Licensed Vocational Nurse - LPN

Job Title:Licensed Vocational Nurse - LPN Job Description Provide processing and communication of Commercial Prior Authorizations for Pharmacy benefits. Review criteria-based prior authorizations following policy and procedure. Refer cases not meeting clinical criteria to the Pharmacist and MD team(s). Handle inbound and outbound calls to facilitate prior authorization requests and inquiries. Document all necessary information accurately using computer systems. Support documentation and communication of medical services and prior authorization determinations. Assist in fax processing and provide telephone assistance for prescriber office staff, pharmacies, and members based on program criteria. ***Critical Information*** Remote, work from home in the USA. Work hours vary between 8:00 AM - 8:00 PM Central Time, with mandatory training from 8:00 AM - 4:30 PM CT. Flexibility to work overtime as needed. Sedentary work involving sitting, talking, listening, and computer use. Regular and predictable attendance required. ***Education/Licenses Needed*** Minimum 2 years clinical experience as a LPN/LVN. Unrestricted license in state of residence or compact license. Relevant certifications, licenses, or degrees related to nursing. Benefits:Benefits are available to full-time employees after 90 days of employment. A 401(k) with company match is available after 1 year of service. View email address on click.appcast.io