What are the responsibilities and job description for the LICENSED VOCATIONAL NURSE position at VIVA USA Inc.?
Licensed Vocational Nurse
Not Disclosed
Woonsocket, RI (100% Remote)
6 Months
Not Disclosed
Not Disclosed
Pharmaceutical
$20.98/hour - $25.98/hour
Job Posted on (Mar 31, 2025)
Reference Number: KBRILV30
Description
Job Description
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.
Hold and maintain an active, unencumbered LPN/LVN license in the state of practice.
North Carolina licensure preferred
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)
Position Summary
Review complex clinical criteria-based prior authorizations (electronically and/or in written format) in accordance with client 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.
Education
The Licensed Practical Nurse is a graduate of a school of Practical or Vocational 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/LVN must have a full, active and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory or Commonwealth of the United States or District of Columbia.
Candidate should be located and licensed in North Carolina for a specific project
Notes
This position is a 100% remote, work from home opportunity and will not be patient facing.
Shift range: Sunday – Saturday 8:00 AM – 6:00 PM.
Candidates MUST HAVE prior authorization experience in an MDO, PBM, or a clinical setting.
Schedule: For training there is a set schedule 7am-330pm CST Monday-Friday. Following training, they will have a permanent schedule. Shift range varies and are subject to change.
Schedule Training: Mon - Fri. 8am - 430 PM EST Starting 06/2/2025. Training will be 2-4 weeks.
Fully remote (never coming onsite)
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Not Disclosed
Woonsocket, RI (100% Remote)
6 Months
Not Disclosed
Not Disclosed
Pharmaceutical
$20.98/hour - $25.98/hour
Job Posted on (Mar 31, 2025)
Reference Number: KBRILV30
Description
Job Description
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.
Hold and maintain an active, unencumbered LPN/LVN license in the state of practice.
North Carolina licensure preferred
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)
Position Summary
Review complex clinical criteria-based prior authorizations (electronically and/or in written format) in accordance with client 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.
Education
The Licensed Practical Nurse is a graduate of a school of Practical or Vocational 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/LVN must have a full, active and unrestricted license as a Licensed Practical or Vocational Nurse in a State, Territory or Commonwealth of the United States or District of Columbia.
Candidate should be located and licensed in North Carolina for a specific project
Notes
This position is a 100% remote, work from home opportunity and will not be patient facing.
Shift range: Sunday – Saturday 8:00 AM – 6:00 PM.
Candidates MUST HAVE prior authorization experience in an MDO, PBM, or a clinical setting.
Schedule: For training there is a set schedule 7am-330pm CST Monday-Friday. Following training, they will have a permanent schedule. Shift range varies and are subject to change.
Schedule Training: Mon - Fri. 8am - 430 PM EST Starting 06/2/2025. Training will be 2-4 weeks.
Fully remote (never coming onsite)
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
Salary : $21 - $26
