Licensed Vocational Nurse - LPN

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.
• Digital charting
• Managed care or health plan previous experience,
• Call center experience
• Multi-tasking experience
• Prior remote experience preferred
• Case Management experience
• Prior authorization experience
• High production experience
• Excellent organizational skills. Strong detail orientation.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

#mcb