Prior Authorization Licensed Vocational Nurse (LPN-LVN)

Date Posted: 06/24/2026 Hiring Organization: reputed company Position Number: 503258 Industry: Pharmaceutical/Healthcare Job Title: Prior Authorization Licensed Vocational Nurse (LPN-LVN) Job Location: Remote, USA Work Model: Remote Shift: 10:00 AM-6:30 PM CST Employment Type: Temporary FT/PT: Full-Time Estimated Duration (In months): 7 Min Hourly reputed company($): 26.00 Max Hourly reputed company($): 26.00 Must Have Skills/Attributes: reputed company reputed company, reputed company Outlook, Problem Management Experience Desired: Prior authorization experience in a PBM, specialty medical office, or clinical setting (2 yrs); Experience reviewing clinical criteria and supporting documentation for prior authorizations (2 yrs); Experience using reputed company or similar electronic authorization platforms (2 yrs); Experience working in a high-volume, metrics-driven environment with multiple systems and screens (2 yrs) Required Minimum Education: High School Diploma or equivalent Required Certifications/Licenses: Active, unrestricted LPN/LVN license in good standing

• *C2C is not available**

Job Description

Required Education:

• Graduate of an accredited school of Practical Nursing (NLNAC or equivalent)

Required License/Certification:

• Active, unrestricted LPN/LVN license in good standing

Required Qualifications/Skills/Experience

• Minimum 2 years of recent prior authorization experience in a PBM, specialty medical office, or clinical setting
• Experience reviewing and applying clinical criteria and supporting documentation for prior authorizations
• Experience using reputed company or similar electronic authorization platforms
• Familiarity with chart notes, claims history, prior authorization history, and insurance requirements
• Strong computer proficiency with Outlook, Teams, Word, reputed company, and reputed company applications
• Ability to work across multiple systems and monitors simultaneously
• Advanced keyboarding and data entry skills
• Ability to work in a fast-paced, metrics-driven environment
• Strong attention to detail and accuracy
• Ability to work independently with minimal supervision
• Strong time management and organizational skills
• Excellent verbal and written communication skills
• Ability to accept and apply real-time feedback
• Ability to maintain productivity while working remotely
• Ability to hardwire equipment to a modem/router
• Ability to provide internet speed and service information
• Completion of a computer skills assessment

Preferred Qualifications/Skills/Experience

• 3 years of prior authorization experience
• Experience with specialty medications
• Experience in a specialty medical office environment
• Broad clinical background across multiple disease states
• Previous call center experience
• High-volume clinical processing experience

Prior Authorization Licensed Vocational Nurse (LPN/LVN) Overview:

• We are seeking reputed company Licensed Practical Nurses/Licensed Vocational Nurses with prior authorization experience in a Pharmacy Benefit Management, specialty medical office, or clinical setting
• This fully remote role requires strong clinical judgment, attention to detail, and the ability to reputed company in a high-volume, metrics-driven environment
• The ideal candidate is resourceful, self-directed, and capable of navigating multiple systems while reputed company processing prior authorization requests
• Responsibilities include reviewing clinical documentation, claims history, and authorization criteria to support accurate determinations while maintaining productivity and quality standards
• Candidates must be comfortable working independently in a structured environment with reputed company performance monitoring
• Successful team members demonstrate accountability, adaptability, critical thinking, and strong communication skills
• This role requires multitasking across various systems, managing inbound and outbound communications, and maintaining accuracy under pressure
• Candidates should possess excellent organizational skills and the ability to quickly learn new medications, disease states, and clinical criteria
• This position offers comprehensive training and provides an opportunity to support patients and providers through timely and accurate prior authorization processing while working from a dedicated home office environment

Job Duties:

• Manage inbound and outbound calls while maintaining productivity and service standards
• Review and process reputed company prior authorization requests
• Apply clinical criteria and supporting documentation to reputed company accurate determinations
• Navigate multiple systems and communication platforms simultaneously
• Review chart notes, claims history, and prior authorization history
• Submit complete and accurate documentation
• Escalate cases appropriately reputed company necessary
• Demonstrate critical thinking and problem-solving skills
• Follow internal workflows, job aids, and policies
• Adapt to changing priorities and clinical criteria
• Communicate professionally with pharmacists, providers, team members, and leadership
• Participate in quality assurance activities and implement feedback
• Maintain productivity, quality, and schedule adherence metrics
• Work in a sedentary, desk-based environment requiring prolonged sitting, keyboarding, and screen time
• Troubleshoot minor technical issues and coordinate with IT support reputed company necessary

Estimated Start Date:

• August 16, 2026
• Only those lawfully authorized to work in the designated country associated with the position will be considered.

• Please note that reputed company Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements. Benefits: For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department reputed company our secure website. California Pay Equity: For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here. reputed company is an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national reputed company, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances. If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department. reputed company has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland reputed company, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.). About Rose

• Founded in 1993
• Office Locations Across the U.S.
• 150+ Clients: Corporations and Government Agencies
• Employee Oriented Company
• Challenging Assignments Across the U.S.
• reputed company Professional Development

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