Licensed Practical Nurse

Apidel Technologies; Chandler (AZ); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading staffing and recruiting company is seeking a Licensed Practical Nurse for a fully remote position. This entry-level role involves reviewing prior authorizations and ensuring compliance with healthcare standards. Ideal candidates will have graduated from an accredited nursing program and hold an active nursing license.

Qualifications

• Full, active, and unrestricted license as a Licensed Practical or Vocational Nurse in the U.S.
• North Carolina licensure preferred.

Responsibilities

• Review complex clinical criteria-based prior authorizations.
• Participate in quality assurance activities.
• Utilize clinical skills for documentation review and authorization determinations.

Skills

Clinical and problem-solving skills

Multitasking

Prioritization

Adaptability

Education

Graduate of an approved Practical or Vocational Nursing program

Job description

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This job was posted by azjobconnection.gov. For more information, please see: Job Details.

Position Details

• Position: Licensed Practical Nurse
• Location: Fully remote (never coming onsite)
• Duration: 06+ months (with possible extension)
• Shift: Mon - Fri. 8am - 4:30 PM EST

Duties

• Review complex clinical criteria-based prior authorizations electronically and/or in written format in accordance with CVS/Caremark policies and procedures and per the health plan/employer agreed criteria.
• Refer prior authorization cases not meeting clinical criteria for upper-level review when appropriate.
• Follow all prior authorization procedures to meet business quality standards and ensure compliance with regulatory requirements and accreditation standards.
• Participate in quality assurance activities, including reviewing work instructions and job aids regularly.
• Collaborate with team members, pharmacists, healthcare professionals, clients, leaders, and other stakeholders.
• Complete other prior authorization assignments as delegated by leadership.
• Utilize clinical and problem-solving skills to support documentation review, communication of medical services, and authorization determinations.
• Ability to multitask, prioritize, and adapt in a fast-paced environment.
• This position involves sedentary work, extended sitting, telephone communication, using multiple computer programs, and keyboarding.
• Must have regular and predictable attendance and be willing to work overtime and weekends as required.

Qualifications

• Graduate of an approved Practical or Vocational Nursing program, accredited by the National League for Nursing (NLNAC) or similar.
• Full, active, and unrestricted license as a Licensed Practical or Vocational Nurse in the U.S. (North Carolina licensure preferred).

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Health Care Provider
• Industry: Staffing and Recruiting