Our Client, a Retail Pharmacy company, is looking for a Licensed Vocational Nurse - LPN for their Remote location.
Responsibilities:
Review criteria-based prior authorizations following policy and procedure
Provide internal nurse support to the PA team and member services department Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).
Shift priorities while exhibiting a high level of urgency with all calls and assignments.
You will work with pharmacists, other clinical colleagues, healthcare professionals and members.
Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
Complete other PA assignments as delegated by the PA leadership team.
Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations
Ability to multitask, prioritize, and effectively adapt to a fast paced changing environment
This position involves sedentary work with periods of sitting, talking, listening.
Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
Position requires proficiency with computer skills which include navigating multiple systems and keyboarding
Excellent communication skills, both written and verbal
Must have regular and predictable attendance
Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve calls with a one call solution.
Performs other related projects and duties as assigned, including attending training sessions and development meetings.
Requirements:
Minimum 2 years clinical experience as a LPN/LVN.
A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in their state of residence or a compact license.
Prior authorization experience or Case Management experience
3+ years prior related clinical work experience
Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations.
Experience using MS Office and other Windows-based computer applications and phone use.