LPN/LVN Prior Authorization Nurse

Job Summary

To support a growing healthcare team, the full-time LPN/LVN Prior Authorization Nurse will review and process complex prior authorization requests, manage inbound and outbound calls, and maintain productivity in a remote environment.

Key responsibilities

• Review and process complex prior authorization requests while maintaining accuracy and quality
• Manage inbound and outbound communications with team members, pharmacists, providers, and leadership
• Navigate multiple systems and apply clinical criteria and workflows to ensure compliance and efficiency

Required qualifications

• Active, unrestricted LPN/LVN license in the state of residence
• 2+ years of prior authorization experience in a PBM, MDO, or clinical setting
• Experience with CoverMyMeds or similar prior authorization platforms
• Strong computer proficiency and ability to multitask across multiple systems
• High School Diploma or equivalent education