Remote Hiring for Licensed Vocational Nurse Fully remote (Never Coming Onsite)

LanceSoft, Inc. • Contract • Rhode Island, United States, US • $25 - $28 / hour • 1w ago

Job Description:
Job ID: 25-285828
Job Title: ‘Licensed Vocational Nurse’
Estimated Length of Assignment: 6+ Months (with possible extension)
(The dates provided are only an estimate and not a guarantee)
(Never Coming Onsite)
Est. Pay Range: $20.00/hour - $26.00/Hour on W2 (USD)
Work Type: Remote

Schedule:

Schedule Training: Mon - Fri, 8:00 AM - 4:30 PM CST Starting 11/10/2025. Training will be 8 weeks. Potential candidates need to be available during this time. We don’t recommend trainee’s miss anymore than 8 hours of training.

Permanent Shift Range: Work week will be 5 days a week; could include weekdays and weekends. Shift time will be set based on business needs. Shifts may range between 8am - 8pm CST (8 hours shift)

Questionnaire:
Make sure candidate location is at top of resume Please include screenshot of speed test at top of resume.
-How much experience to they have with Prior Authorization in an MDO or clinical setting? and make sure this is present on their resume under each position they have the experience with.
-What is their current availability for work schedule?
-Need a screenshot of their active and unencumbered LVN / LPN license at the top of the resume.

This position is a 100% remote, work from home opportunity and will not be patient facing.

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.
• Must possess excellent communication skills, both written and verbal.
• Shift priorities while exhibiting a high level of urgency and responsiveness with all calls, prior authorization requests, and ADHOC assignments.
• 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.

Experience:
Required Qualifications
• Hold and maintain an active, unencumbered LPN/LVN license in the state of practice.
• Position requires proficiency with computer skills which include multitasking, navigating multiple systems, and keyboarding. Experience using MS Office, other Windows-based computer applications, web based processing and telephony programs.
• Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM).

Preferred Qualifications
• 3+ years prior work experience as an LPN/LVN in a specialty medical office, skilled clinical setting and/or PBM.

Education:
• The Licensed Practical Nurse is a graduate of a school of Practical 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 must have a full, active, and unrestricted license as a Licensed Practical in a State, Territory or Commonwealth of the United States or District of Columbia.

Position Summary
Candidates MUST HAVE prior authorization experience in an MDO, PBM, or a clinical setting.
Schedule: For training there is a set schedule 8am-430pm CST Monday-Friday. Following training, they will have a permanent schedule. Shift range varies and are subject to change.
Shift range: Sunday - Saturday 8:00 AM - 6:00 PM. New hires will be expected to work a weekend shift ongoing as part of their permanent schedule rotation (Sunday-Thursday or Tuesday-Saturday).

• 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.
• Must possess excellent communication skills, both written and verbal.
• Shift priorities while exhibiting a high level of urgency and responsiveness with all calls, prior authorization requests, and ADHOC assignments.
• 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.

Employee Benefits:
At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:

Four options of medical Insurance
Dental and Vision Insurance
401k Contributions
Critical Illness Insurance
Voluntary Permanent Life Insurance
Accident Insurance
Other Employee Perks

If you believe you're qualified for this position and are currently in the job market or interested in making a change, please give me a call as soon as possible at 703-889-6809.