California Licensed Vocational Nurse

Job Summary

To support a specialty medical Prior Authorization department, the full-time California Licensed Vocational Nurse will manage inbound calls, process Prior Authorization requests, and communicate with healthcare professionals in a remote setting.

Key responsibilities

• Manage inbound calls and fax requests while maintaining professional communication
• Review and process criteria-based Prior Authorizations, ensuring compliance with established policies
• Document all required information accurately and provide support to the Prior Authorization team

Required qualifications

• Active and unrestricted California Licensed Vocational Nurse license
• High school diploma or equivalent, with graduation from an approved Practical or Vocational Nursing program
• 1-3 years of relevant experience in Prior Authorization within an MDO, PBM, or clinical setting
• Experience with criteria-based clinical review and established Prior Authorization procedures
• Strong computer skills and experience with data entry and documentation