Prior Authorization Nurse Associate LPN/LVN - Remote Texas - CVS Health - Immediate Openings Available

Join the CVS Health Team as a Prior Authorization Nurse Associate LPN/LVN - Remote

CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. We are seeking a highly skilled and compassionate Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) to join our team as a Prior Authorization Nurse Associate. This is a 100% remote opportunity to work from home in the USA, providing processing and communication of Commercial Prior Authorizations (PA) for Pharmacy benefits.

About CVS Health

At CVS Health, we share a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric healthcare for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.

Position Summary

As a Prior Authorization Nurse Associate LPN/LVN, you will play a critical role in our Pharmacy Operations team, working remotely from home in Texas. You will be responsible for processing and communicating Commercial Prior Authorizations (PA) for Pharmacy benefits, working closely with physician office staff, customer service, admissions, and pharmacy operations departments.

Key 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
• 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
• Utilization of clinical skills to support the documentation and communication of medical services and prior authorization determinations
• Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment

Requirements and Qualifications

Essential Qualifications:

• Minimum 2 years of clinical experience as a LPN/LVN
• A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in the state of residence
• Must be willing and able to work 8-hour shifts Monday through Friday, between 8am and 8pm in the time zone of residence
• Must be willing and able to work occasional weekends per business needs

Preferred Qualifications:

• 3+ years of prior related clinical work experience
• Experience using MS Office and other Windows-based computer applications and phone use
• Digital charting
• Managed care or health plan previous experience
• Call center experience
• Multi-tasking experience
• Prior remote experience
• Case Management experience
• Prior authorization experience
• High production experience

Education

• LVN/LPN Diploma
• Associate's degree in nursing as LPN/LVN

Work Environment and Culture

CVS Health is committed to creating a work environment that is inclusive, diverse, and supportive of all employees. We offer a range of benefits and programs to support our employees' well-being, including:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Discount programs with participating partners
• Paid Time Off (PTO) or vacation pay
• Paid holidays throughout the calendar year

Compensation and Benefits

The typical pay range for this role is:

• $22.40 - $48.67 per hour

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors, including experience, education, geography, and other relevant factors.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to supporting the career growth and development of our employees. We offer a range of training and development programs, including:

• New hire training programs
• Ongoing training and development opportunities
• Leadership development programs
• Tuition reimbursement
• Mentorship programs

Why Join CVS Health?

CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. We offer a range of benefits and programs to support our employees' well-being, as well as opportunities for career growth and development.

If you are a motivated and compassionate LPN/LVN looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Prior Authorization Nurse Associate LPN/LVN, you will play a critical role in our Pharmacy Operations team, working closely with physician office staff, customer service, admissions, and pharmacy operations departments.

Apply now and join our team as a Prior Authorization Nurse Associate LPN/LVN - Remote Texas - CVS Health - Immediate Openings Available!

Apply Now