Registered Nurse - Remote Refill & Prior Authorization Lead

St. Luke's University Health Network; Bethlehem (Northampton County); Hybrid; USD 75,000 - 95,000; Full time

Job summary

St. Luke's University Health Network in Bethlehem, PA, is seeking a Registered Nurse, Rx Refill and Prior Authorization Specialist for the Behavioral Health Navigation Center.

The hybrid role combines remote work with on-site collaboration on Broadhead Rd to deliver exceptional patient experiences through efficient medication refill and prior authorization workflows. You will mentor Rx Refill Specialists, manage prior authorization queues, liaise with providers, insurers, and practices, and

Qualifications

• Requires RN licensure in Pennsylvania and nursing degree education.
• Minimum three years of clinical experience in a pharmacy or related office.
• Experience with patient interactions over the phone is required.
• Leadership or management experience preferred; telework may be possible under policy.

Responsibilities

• Process incoming phone and electronic patient medication refills and prior authorization requests.
• Engage patients with courtesy and compassion during interactions.
• Review records and refill protocols to support appropriate refills.
• Escalate to prescribing providers when protocol criteria are not met.
• Coordinate with insurers, practices and pharmacies to address refill and authorization needs.
• Mentor Rx Refill Specialists and serve as SME for refill/ref authorization processes.

Skills

Leadership/Management

Patient communication

Pharmacy workflows

Prior authorization processes

Epic Cadence experience

Remote work readiness

Education

RN licensure in PA

Bachelor's in Nursing preferred

Tools

Epic Cadence

EHR systems

Insurance verification systems

Job description

St. Luke's University Health Network in Bethlehem, PA, is seeking a Registered Nurse, Rx Refill and Prior Authorization Specialist for the Behavioral Health Navigation Center.

The hybrid role combines remote work with on-site collaboration on Broadhead Rd to deliver exceptional patient experiences through efficient medication refill and prior authorization workflows. You will mentor Rx Refill Specialists, manage prior authorization queues, liaise with providers, insurers, and practices, and