Licensed Practical Nurse

at Apidel Technologies LLC in Wichita, Kansas, United States

Job Description

Position: Licensed Practical Nurse

Location: Fully remote (never coming onsite)

Duration: 06+ months (with possible extension)

Shift: Mon - Fri. 8am - 430 PM EST

Duties

• Review complex clinical criteria-based prior authorizations (electronically and/or in written format) in accordance with CVS/Caremark policies and procedures and per the health plan/employer agreed criteria.
• Refer prior authorization cases not meeting clinical criteria for upper-level review when appropriate.
• Follow all prior authorization procedures to meet business quality standards and ensuring the operational unit is complying with regulatory requirements and accreditation standards.
• Participates in quality assurance activities on ongoing basis, including but not limited to reviewing work instructions and job aids regularly.
• Collaborate with representatives on the prior authorization team, pharmacists, clinical colleagues, healthcare professionals, clients, leaders, and team members.
• Complete other prior authorization assignments as delegated by the leadership team.
• Utilization of clinical and problem-solving skills to support the research of documentation, communication of medical services, and prior authorization determinations.
• Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment.
• This position involves sedentary work with extended periods of sitting, talking on the telephone, using multiple programs on multiple computer screens, and keyboarding.
• Must have regular and predictable attendance.
• Colleague will be required to work business required overtime/work weekends when business requires.

Education

• 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. *North Carolina licensure preferred