Remote Prior Authorization Nurse (LPN/LVN)

CVS Health; United States; Remote; USD 28,929 - 73,012; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) for a 100% remote, work-from-home role in the USA. You will process and communicate Commercial Prior Authorizations for pharmacy benefits and collaborate with PA team, physicians, and customer service to relay referral status.

Responsibilities include inbound calls, loading authorizations, follow-up, and maintaining accurate documentation in the system.

Qualifications

• LVN/LPN diploma and active license in state of residence or compact license.
• Minimum 2 years clinical experience as an LPN/LVN.
• Prior authorization or case management experience.
• Experience using MS Office and Windows-based applications.
• Remote work experience preferred and strong documentation skills.

Responsibilities

• Review criteria-based prior authorizations following policy and procedure.
• Provide internal nurse support to the PA team and member services department.
• Refer cases not meeting clinical criteria to the pharmacist and MD team(s).
• Handle inbound and outbound calls to facilitate prior authorization requests.
• Maintain accurate documentation in the computer system.

Skills

Communication skills

MS Office

Remote work

Multitasking

Customer service

Time management

Education

LVN/LPN diploma

Associate’s degree in nursing

Tools

MS Office

Digital charting

Job description

CVS Health is seeking a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) for a 100% remote, work-from-home role in the USA. You will process and communicate Commercial Prior Authorizations for pharmacy benefits and collaborate with PA team, physicians, and customer service to relay referral status.

Responsibilities include inbound calls, loading authorizations, follow-up, and maintaining accurate documentation in the system.