1. This position is a 100% remote, work from home in the USA opportunity and will not be patient facing. 2. The Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN) will provide processing and communication of Commercial Prior Authorizations (PA) reviewed by the Commercial PA team for Pharmacy benefits. * Minimum 2 years clinical experience as a LPN/LVN. * Prior authorization experience or Case Management experience * A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in their state of residence, with multi-state/compact privileges and have the ability to be licensed in all non-compact states. • 3+ years prior related clinical work experience • 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 • Case Management experience • Prior authorization experience • High production experience Education 1. The Licensed Practical Nurse is 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 by the applicant. 2. The LPN/LVN must have a full, active and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory or Commonwealth of the United States or District of Columbia.
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 as needed, 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.
Best Value
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