Licensed Vocational Nurse

Job Title: Licensed Vocational Nurse
Location: 100% Remote (Must reside in the U.S.)– RI 02895
Duration: 6 Months+ and Possibility of Extension
 
Pay Rate: $26/hr. on W2

Schedule:

• Training: Monday–Friday, 8:00 AM – 4:30 PM CST (8 weeks) — no absences permitted beyond 8 hours
• Post-training: 8-hour shifts between 8:00 AM – 8:00 PM CST
• Permanent Schedule: 5 days/week (must include one weekend day; i.e., Sunday–Thursday or Tuesday–Saturday)
• OT and weekend work may be required

 
Position Summary:
This fully remote LPN/LVN position involves reviewing and processing clinical prior authorizations for specialty medications under both Pharmacy and Medical benefits. This is a non-patient-facing role with a strong emphasis on clinical review, documentation accuracy, phone-based communication, and adherence to health plan criteria.
You will work in coordination with physicians’ offices, pharmacists, and other internal departments to provide high-quality, timely, and compliant service.
 
Key Responsibilities:

• Review and process complex prior authorization (PA) requests based on established criteria.
• Document case reviews accurately in accordance with operational and regulatory standards.
• Communicate clearly with prescriber offices, pharmacies, members, and internal teams.
• Refer non-compliant or complex cases to upper-level clinical reviewers when necessary.
• Prioritize and manage multiple case files in a fast-paced, regulated environment.
• Participate in quality assurance and continuous improvement activities.
• Stay up-to-date with evolving healthcare regulations and prior authorization criteria.

 
Required Qualifications:

• Active, unencumbered LPN/LVN license in any U.S. State or Territory.
  • License must not expire within the first 90 days of assignment.
• 2+ years of experience in a prior authorization role within one of the following settings:
  • Medical Doctor’s Office (MDO)
  • Specialty Clinical Setting
  • Pharmacy Benefit Manager (PBM)
• Proficient in multitasking across multiple computer programs and screens.
• Strong communication skills – written and verbal.
• Proficiency in MS Office and web-based systems.
• Reliable internet connection (must provide screenshot of speed test with resume).

 
Preferred Qualifications:

• 3+ years experience as an LPN/LVN in specialty care, PBM, or high-volume prior auth roles.
• Prior experience with Caremark, CVS, or commercial health plans.
• Familiarity with Medicare/Medicaid prior authorization workflows.

 
Pre-Screen Requirements (MUST be included with submission):

1. Resume with current location at the top
2. Screenshot of internet speed test
3. Copy of active LPN/LVN license (with clear expiration date)
4. Availability confirmation for training and permanent shift

 
Key Dates:

• Target Offer Date: October 13, 2025
• Licensing/Clearance Deadline: October 31, 2025

 
Work Requirements:

• Ability to sit for extended periods and work at a computer across multiple platforms.
• Regular and predictable attendance is essential.
• Willingness to work business-required overtime, holidays, or weekends when needed.