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Licensed Vocational Nurse - LPN

US Tech Solutions, Inc.

Please note: Actual location may vary., RI

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JOB DETAILS
SALARY
$25–$27 Per Hour
JOB TYPE
Temporary, Contractor, Full-time
SKILLS
Case Management, Clinical Competency, Clinical Medicine, Clinical Support, Computer Skills, Computer Systems, Customer Support/Service, Data Entry, Data Management, Documentation, Establish Priorities, Healthcare, Healthcare Providers, Leadership, Licensed Practical Nurse/Licensed Vocational Nurse, Medical Office, Multitasking, Nursing, Operational Communications, Operations Management, Patient Care Authorizations, Pharmacy, Support Documentation, Telephone Skills, Typing
LOCATION
Please note: Actual location may vary., RI
POSTED
20 days ago
Duration: 6+ months contract
Shift: Work hours vary from 8AM to 8PM CST. Training hours 8AM - 430PM CT. Mandatory OT.

Position Summary:
The Licensed Practical Nurse (LPN) will provide processing and communication of Commercial Prior Authorizations (PA) reviewed by the Commercial PA team for Pharmacy benefits. Reporting to the Pharmacy Operations Manager, working with physician office staff and customer service, admissions and pharmacy operations departments to communicate referral status. You will also oversee fax processing and providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria. Responsibilities include answering inbound phone calls, processing cases, loading authorizations, and making follow-up phone calls. Maintaining complete and accurate, documentation of all necessary information is necessary and will involve computer system data entry, data management, and reporting.

Duties:
  • 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
  • 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.
 
Experience:
  • 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
 
Education:
• 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.
 
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
 
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran
 

About the Company

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US Tech Solutions, Inc.