Pipeline-Registered Nurse II

Mindlance; Houston (TX); Remote; USD 70,000 - 90,000; Full time

Job summary

Mindlance is seeking a Licensed RN for a virtual position focused on clinical prior authorization setup. This role involves translating clinical policy requirements and providing consultative support while maintaining effective communication with clients. The successful candidate will enjoy a collaborative work environment and will need strong Microsoft Office skills.

Qualifications

• RN license in good standing required.
• Strong communication and organizational skills.
• Attention to detail is critical.

Responsibilities

• Manage prior authorization setup without direct patient care.
• Support configuration for pharmacy and medical criteria.
• Provide consultative support with effective communication.

Skills

Communication

Organizational

Collaboration

Attention to detail

Strategic thinking

Education

Licensed RN in good standing

Tools

Microsoft Office (especially Excel)

Job description

Duties

• No direct patient care. This is a virtual position.
• Responsible for clinical criteria prior authorization setup, which involves translating client clinical policy requirements into prior authorization requests sent to prescribers. This includes creating questions such as (but not limited to) patient age, medication history, and previous treatments. The questions and answers facilitate prescriber responses leading to approval or denial. Clinicians also create and code denial rationales sent to prescribers and patients, using a proprietary web-based platform, for which training will be provided. Strong skills in Microsoft Office, particularly Excel, are required.
• Provide configuration support for pharmacy and medical criteria, requiring creative problem-solving to meet client needs and optimize efficiency.
• Offer consultative support by explaining setup and system requirements when discussing criteria setup with internal client partners. Effective communication skills are highly valued.

Skills

• Excellent communication, organizational, and collaboration skills.
• Demonstrates a team-oriented approach and strategic thinking.
• Accountable for client relationships and service delivery.
• Develops operational controls to maximize service levels.
• Identifies system or process change needs to improve service.
• Clearly articulates responsibilities and controls.
• Mitigates concerns of business partners within scope.
• Communicates effectively with clients during consultative services.

Non-Negotiable Skills

• Licensed RN in good standing as per state requirements.
• Strong communication skills.
• Attention to detail.

Education

RN license in good standing as required by the state of employment.

EEO: Mindlance is an Equal Opportunity Employer and does not discriminate based on minority, gender, disability, religion, LGBTQI, age, or veteran status.