Texas Licensed Prior Authorization Nurse

Job Summary

To support a leading managed care organization, the remote Texas Licensed Prior Authorization Nurse will process specialty medication prior authorization requests, communicate with healthcare professionals, and maintain accurate documentation while working on a contract basis.

Key responsibilities

• Review criteria-based prior authorizations and ensure compliance with established policies
• Provide on-call support for urgent prior authorization requests after hours
• Assist prescriber office staff and pharmacies with inquiries and follow-up communications

Required qualifications

• Active, unrestricted LPN or LVN license in the candidate's state of residence or a valid compact license
• Minimum of 2 years of clinical experience as an LPN/LVN
• Prior authorization experience in a managed care organization, pharmacy benefit manager, or clinical setting
• Experience in a high-volume, metrics-driven healthcare environment
• Ability to work independently in a fully remote environment