Licensed Vocational Nurse

Job Title: Licensed Vocational Nurse
Job Location: RI
Job Duration: 6 Months (possibility of extension)
Payrate: $25.97/ hr on w2

Training Schedule:

• Training schedule is approximately 5 weeks starting 11/3/2025, Monday to Friday 8:00am - 4:30pm CST.
• Expected shifts to be 8 hours per day, which may also include one weekend day per week.
• Candidates in MT and PT time zones are preferred.
• Training is M-F 8am-4:30pm CST for 5 weeks then M-F: 8am-5 pm CST.

Job Summary:

• Review criteria-based prior authorizations following policy and procedure.
• Provide on-call after hours nurse availability for urgent PA requests.
• 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).
• Shift priorities while exhibiting a high level of urgency with all calls and assignments.
• Excellent verbal and written skills.
• You will work with pharmacists, other clinical colleagues, healthcare professionals and members.
• Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
• Complete other PA assignments as delegated by the PA leadership team.

Duties:

• Provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Healthcare Specialty Medical Prior Authorization department.
• Report to the Pharmacy Operations Manager.
• Work with physician office staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status.
• Oversee fax processing and provide telephone call assistance for prescriber office staff, pharmacies and members based on program criteria.
• Answer inbound phone calls, process cases, load authorizations, and make follow-up phone calls.
• Maintain complete and accurate documentation of all necessary information.
• Perform computer system data entry, data management, and reporting.

Qualifications and Skills:

• 1+ years prior clinical work experience.
• Excellent interpersonal skills.
• Demonstrated problem-solving ability and attention to detail.
• Ability to work effectively in a team environment with great dependability.
• Excellent oral and written communication skills.
• Ability to quickly assess and adapt to constantly changing situations, phone and PC use.
• Required to possess a high mental agility and alertness.
• Ability to effectively communicate with pharmacists, other clinical colleagues, healthcare professionals and members.
• Ability to effectively prioritize work while exhibiting a high level of urgency with all calls and assignments.
• Ability to effectively train and mentor representatives on the PA team.

Licensed Practical Nurse (LPN) Requirements:

• The Licensed Practical Nurse is a graduate of a school of Practical or Vocational Nursing, approved by the State Agency and/or accredited by the National League for Nursing (Accrediting Commission (NLNAC)) at the time the program was completed by the applicant.
• The LPN/LVN must have a full, active and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory or Commonwealth of the United States or District of Columbia.
• Registered Nurses (RNs) not accepted for LVN/LPN roles unless otherwise stated.