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
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