US
0 suggestions are available, use up and down arrow to navigate them
PROCESSING APPLICATION
Hold tight! We’re comparing your resume to the job requirements…
ARE YOU SURE YOU WANT TO APPLY TO THIS JOB?
Based on your Resume, it doesn't look like you meet the requirements from the employer. You can still apply if you think you’re a fit.
Job Requirements of Prior Authorization Nurse Associate:
-
Employment Type:
Contractor
-
Location:
Work From Home, RI (Remote)
Do you meet the requirements for this job?
Prior Authorization Nurse Associate
Careers Integrated Resources Inc
Work From Home, RI (Remote)
Contractor
Job Title: Prior Authorization Nurse Associate
Location: Remote (Work from Home)
Duration: 6 Months+ (Contract With possibility of Extension)
Pay rate: $26/hr. on W2
Position Summary:
The UM Nurse Associate I plays a critical role in supporting the Prior Authorization (PA) process by reviewing and completing criteria-based PA requests, providing nurse availability for urgent requests after hours, and offering internal nurse support to the PA team and Member Services. Cases that do not meet clinical criteria are referred to Pharmacist and MD review teams.
This is a 100% remote contingent position (40 hours/week) requiring participation in a structured training program and ongoing professional development.
Key Responsibilities:
- Promptly answer nurse phone queue calls, including escalated requests.
- Serve as the final decision-maker on PA approvals; refer non-qualifying cases for secondary review.
- Review case volumes, document clinical data accurately, and process all PA paperwork thoroughly.
- Maintain and update desk reference materials as needed.
- Attend training sessions, development meetings, and mentor PA representatives as required.
- Ensure regular, predictable attendance and work mandatory overtime or extended weeks as needed.
- Travel may be required occasionally.
Minimum Requirements:
- Active, unrestricted LPN/LVN license in the state of practice (include license screenshot at the top of your resume).
- High School Diploma or GED (verifiable).
- 1–3 years relevant nursing experience.
- Excellent interpersonal, verbal, and written communication skills.
- Strong problem-solving skills with high attention to detail.
- Ability to prioritize tasks and work efficiently in a fast-paced environment.
- Proficient with PC navigation and phone systems.
- Mental agility, adaptability, and alertness.
- Ability to collaborate effectively with pharmacists, clinicians, healthcare professionals, and members.
- Preferred: Prior remote work experience.
Work Environment:
- Fully remote role; candidates must have a private, quiet home office with a door.
- Hardwired internet connection required (no Wi-Fi).
- Optional: Provide screenshot of home network speed.
Training Details:
- Schedule: 8:00 AM – 4:30 PM CST
- Duration: 4 weeks modular training + 2 weeks nesting
- Note: No pre-scheduled time off allowed during the first 6 weeks
Get job alerts by email.
Sign up now!
Join Our Talent Network!