LPN/LVN Nurse Associate

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

You will be part of a specialized team responsible for processing specialty medication prior authorizations through the medical benefit. You’ll be collaborating with internal non-clinical staff, pharmacists and medical directors. 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 include answering inbound phone calls, processing cases, loading authorizations, and making follow-up phone calls. Maintaining complete and accurate, documentation of all necessary information is required and will involve computer system data entry, data management, and reporting.

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. To be successful in this LPN/LVN position, you'll have Have excellent written and verbal customer service skills, as well as advanced computer skills Ability to effectively prioritize work while exhibiting a high level of urgency with assignments Work effectively in a team environment with great dependability Execute other assignments as delegated by the supervisor or manager. Potential for evening and weekend hours.