Our Client, a Retail Pharmacy company, is looking for a Licensed Vocational Nurse-LPN for their Remote location. Responsibilities:

+ Manage inbound and outbound calls while maintaining productivity, quality, and service level expectations

+ Review and process complex prior authorization requests using clinical criteria and supporting documentation

+ Navigate multiple systems, tools, and communication platforms simultaneously with speed and accuracy

+ Review chart notes, claims history, and prior authorization history to make accurate determinations

+ Submit complete and accurate documentation to support determinations and avoid unnecessary delays

+ Identify cases requiring escalation and refer appropriately

+ Demonstrate critical thinking and problem-solving when information is unclear or incomplete

+ Apply internal workflows, job aids, and policies correctly and consistently

+ Adapt quickly ...