Adecco is currently assisting a National Pharmaceutical client, recruiting for a Licensed Practical Nurse to work REMOTE .
The anticipated wage for this position is between $27 and $28.08. Hourly wage may depend upon experience, education, geographic location and other factors.
Schedule: Training schedule is approximately six weeks starting 8/5/2024, Monday to Friday 8:00am - 4:30pm CST, then schedule will be assigned: Expected shifts to be 8 hours per day, which will include one weekend day per week.
You will provide processing and communication of specialty medication prior authorization (PA) requests reviewed by the Caremark 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:
∙ 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.
∙ Train and mentor representatives on the PA team.
∙ Complete other PA assignments as delegated by the PA leadership team.
Candidates must meet the following requirements to be considered:
Minimum 1 year experience reviewing and processing prior authorizations against health plan criteria for a determination in a clinical setting i.e. medical office or Pharmacy Benefits Manager (PBM)
Must have 3 to 5 years prior related work experience as an LPN/LVN in a medical office, PBM or clinical setting.
Experience using MS Office, other Windows-based computer applications, and phone use.
Work from home requirements:
Workspace is dedicated to business during working hours and is not accessible by others who may be present in the household; telephone conversations cannot be overheard, and documents/computer screens cannot be viewed by others.
You are required to provide your high speed internet speeds.
Smartphones are required. The VPN token will need to be downloaded to the user’s smartphone.
That the assignment could be changed to an in office assignment.
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Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Pay Details: $27.00 to $28.08 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
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The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.