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This job was posted by KansasWorks. For more information, see: Job Details.
Position Details
- Position: Licensed Practical Nurse
- Location: Fully remote (never onsite)
- Duration: 06+ months (possible extension)
- Shift: Mon - Fri, 8am - 4:30pm EST
Duties
- Review complex clinical criteria-based prior authorizations electronically and/or in written format, following CVS/Caremark policies and health plan criteria.
- Refer cases not meeting clinical criteria for upper-level review when appropriate.
- Follow all procedures to ensure quality standards and regulatory compliance.
- Participate in quality assurance activities, including reviewing work instructions and job aids.
- Collaborate with team members, pharmacists, healthcare professionals, clients, and leaders.
- Complete delegated assignments from leadership.
- Utilize clinical and problem-solving skills for documentation, communication, and authorization determinations.
- Multitask and adapt effectively in a fast-paced environment.
- This role involves sedentary work, extended sitting, telephone communication, and computer use.
- Must have regular attendance and be willing to work overtime and weekends as required.
Minimum Qualifications
- Graduate of an approved Practical or Vocational Nursing program.
- Active, unrestricted license as a Licensed Practical or Vocational Nurse in the U.S.
- North Carolina licensure preferred.
Additional Information
- Seniority level: Entry level
- Employment type: Full-time
- Job function: Healthcare Provider
- Industry: Staffing and Recruiting