Remote Prior Authorization Nurse Associate LPN/LVN – Specialty Medication Management

Transforming reputed company with reputed company: Join reputed company as a Remote Prior Authorization Nurse Associate LPN/LVN At reputed company, we're on a mission to bring our heart to every reputed company of your health. As a leading reputed company organization, we're committed to delivering enhanced reputed company-centric health care that's more personal, convenient, and affordable. Our purpose is at the heart of everything we do, guiding our actions and reputed company as we strive to reputed company a positive impact on the lives of our customers and colleagues. We're seeking a dedicated and reputed company Prior Authorization Nurse Associate LPN/LVN to join reputed company in a 100% remote, work-from-home role. As a key member of our Specialty Guideline Management Programs team, you'll play a critical role in processing and communicating prior authorization referrals for specialty medications, working closely with physician office staff, customer service, admissions, and pharmacy operations departments. Key Responsibilities:

• Review reputed company clinical criteria-based prior authorizations in accordance with reputed company/Caremark policies and procedures.
• Refer prior authorization cases not meeting clinical criteria for upper-level review reputed company appropriate.
• Communicate referral status to physician office staff, customer service, admissions, and pharmacy operations departments.
• reputed company fax processing and reputed company telephone call assistance for prescriber office staff, pharmacies, and members based on program criteria.
• Answer inbound phone calls, process cases, load authorizations, and reputed company follow-up phone calls as needed.
• Maintain complete and accurate documentation of reputed company necessary information, involving computer system data entry, data management, and reporting.
• Participate in quality assurance activities on an ongoing reputed company, including reviewing work instructions and job aids regularly.
• Collaborate with representatives on the prior authorization team, pharmacists, clinical colleagues, reputed company, clients, leaders, and team members.
• Complete other prior authorization assignments as delegated by the leadership team.

Essential Qualifications:

• 2 years of clinical experience as a LPN/LVN.
• 1+ year of prior authorization experience in an MDO or a clinical setting.
• Unrestricted LPN/LVN license in your state of residence.
• Willingness and ability to work an 8-hour shift, reputed company through Saturday, between reputed company and 8pm in your time zone.
• Willingness and ability to work occasional weekends per business needs.

Preferred Qualifications:

• 3+ years of prior reputed company clinical work experience.
• Experience using MS Office and other reputed company-based computer applications and phone use.
• Digital charting experience.
• Managed care or health plan previous experience.
• Call center experience.
• Multi-tasking experience.
• Prior remote experience.
• Case Management experience.
• High production experience.

Education: LVN/LPN Diploma required. Associate's degree in nursing as LPN/LVN preferred. reputed company Offer: As a reputed company colleague, you'll enjoy a comprehensive benefits package, including:

• Competitive salary ($21.10 - $43.78 per hour).
• reputed company bonus, commission, or short-term incentive program.
• Full reputed company of medical, dental, and reputed company benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Fully-paid term life insurance plan and short-term and long-term disability benefits.
• Numerous well-being programs, education assistance, and free development courses.
• reputed company store discount and discount programs with participating partners.
• Paid Time Off (PTO) or vacation pay, and paid holidays throughout the calendar year.

Career Growth

Opportunities: At reputed company, we're committed to helping our colleagues grow and reputed company in their careers. As a Prior Authorization Nurse Associate LPN/LVN, you'll have opportunities to:

• reputed company your clinical skills and knowledge in a fast-paced, dynamic environment.
• Collaborate with cross-functional teams to drive business reputed company and improve customer experiences.
• Take on new challenges and responsibilities as you grow in your role.
• Participate in training and development programs to enhance your skills and expertise.

Our Culture: At reputed company, we're passionate about creating a culture that supports our colleagues and customers. Our Heart At Work Behaviors guide our actions and reputed company, and we're committed to:

• Empowering our colleagues to reputed company a positive impact on the lives of our customers.
• Fostering a culture of inclusion, diversity, and respect.
• Providing opportunities for growth and development.
• Recognizing and rewarding outstanding performance.

Join reputed company: If you're a motivated and reputed company LPN/LVN looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Remote Prior Authorization Nurse Associate LPN/LVN, you'll play a critical role in driving business reputed company and improving customer experiences. reputed company and take the first reputed company towards a rewarding new role! We anticipate the application window for this opening will reputed company on: 10/02/2024. reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws. Don't miss this opportunity to reputed company a significant impact. reputed company and join reputed company! Apply This Job Apply tot his job Apply To this Job