[Hiring] Licensed Vocational Nurse @US Tech Solutions

Role Description

This is a remote position and requires the ability to effectively support a work from home environment. Must have the ability to work in a HIPAA compliant work area away from distractions.

You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Specialty Medical Prior Authorization department. Reporting to the Pharmacy Operations Manager, you will work with physician office staff and customer service, admissions and pharmacy operations departments to communicate prior authorization status. You will also oversee fax processing and provide telephone call assistance for prescriber office staff, pharmacies and members based on program criteria.

Responsibilities:

• Answer inbound phone calls, process cases and electronic authorizations, load authorizations, and make follow-up phone calls utilizing appropriate courteous and professional behavior based upon established standards.
• Maintain complete and accurate documentation of all necessary information involving computer system data entry, data management, and reporting.
• 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.
• Work with pharmacists, other clinical colleagues, healthcare professionals and members.
• Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
• Train and mentor representatives on the PA team.
• Complete other PA assignments as delegated by the PA leadership team.

Qualifications

• 1-3 years of related work experience.

Requirements

• High School Diploma or equivalent required.
• Associate’s or Bachelor’s Degree: Nursing preferred.
• Active LPN license in the state of practice required.

Company Description

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.