Safety
Ramp Timeline:
Last Offer Out: July 19, 2026: (4 weeks prior)
Last Candidate Acceptance: July 21 – July 23, 2026 (2–4 days after last offer)
Last Day to Clear (compliance/background): August 6, 2026 (10 days prior to start)
DT must be completed within 72 hours once the candidate reaches 30 days prior to the start date. If within 30 days, DT must be completed within 72 hours of acceptance. Ensure candidates can meet this requirement prior to accepting failure to comply will result in work order closure.
Position Summary
We are seeking experienced LPN/LVN candidates with prior authorization experience in a specialty medical office (MDO), PBM, or clinical setting. This role requires the ability to work in a high-volume, metrics-driven environment while maintaining strong clinical judgment, accuracy, and efficiency.
Successful candidates are self-directed, resourceful, and adaptable, with the ability to quickly interpret clinical information, navigate multiple systems simultaneously, and maintain productivity while managing competing priorities. This is a fully role requiring a high level of accountability, focus, and independence throughout the entire shift.
Prescreen Requirements
Submit prescreen answers along with resume- for all questions
Provide internet speed and service type
Must be able to hardwire PC into modem/router
Submit copy of active LPN/LVN license with expiration date
Submit completed computer skills assessment with resume
Must have prior authorization experience in an MDO, PBM, or clinical setting
Training Schedule
Monday–Friday, 8:00 AM–4:30 PM CST
Training duration: 8 weeks (may extend due to holidays)
Permanent Schedule
Schedules are assigned based on business needs and may include:
Sunday–Thursday or Tuesday–Saturday
Shifts between 10:00 AM–6:30 PM CST
Schedule flexibility, overtime, and weekend availability are required.
Key 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 to changing priorities, processes, and clinical criteria
Communicate clearly and professionally with team members, pharmacists, providers, and leadership
Ask questions and seek clarification when needed to ensure accuracy
Maintain attention to detail while processing high volumes of work efficiently
Participate in quality assurance activities and apply feedback for continuous improvement
Perform work in a sedentary, desk-based environment requiring prolonged sitting, typing, and screen time
Maintain consistent attendance, productivity, and adherence to scheduled work hours
Required Qualifications
Active, unrestricted LPN/LVN license
Minimum 2 years of recent prior authorization experience in a PBM, MDO, or clinical setting
Experience reviewing and applying clinical criteria and supporting documentation for Client
Experience using CoverMyMeds or similar authorization platforms
Familiarity with chart notes, claims history, and insurance requirements
Technical Skills
Strong computer proficiency across multiple systems (Outlook, Teams, Word, Excel, etc.)
Ability to multitask across multiple monitors and applications simultaneously
Advanced keyboarding skills, with the ability to type quickly and accurately
Behavioral and Work Style Requirements
Proven ability to work in a fast-paced, high-production, metrics-driven environment
Strong attention to detail while maintaining speed and accuracy
Ability to learn quickly and work independently with limited guidance
Strong time management and organizational skills in a setting
Ability to remain focused and productive while working independently for full shifts
Comfortable working in a structured, highly monitored environment with performance metrics
Strong written and verbal communication skills, including the ability to clearly articulate clinical information and medication names
Ability to receive, apply, and act on real-time feedback
Preferred Qualifications
3 years of prior authorization experience
Experience in a specialty medical office or with specialty medications
Broad clinical background across multiple disease states
Previous call center or high-volume clinical processing experience
What Makes Someone Successful in This Role
Successful team members consistently demonstrate:
Ability to work under pressure while maintaining accuracy and productivity
Demonstrated ownership, reliability, and accountability for performance
Resourcefulness able to locate and interpret information independently before escalating
Confidence to ask questions, seek clarification, and speak up when unsure
Ability to quickly learn new medications, disease states, and clinical criteria
Strong multitasking ability across systems, workflows, and communication tools
Excellent attention to detail combined with processing speed
Resilience and adaptability able to adjust to frequent changes and challenges
Ability to remain focused and productive despite obstacles, system issues, or changing priorities
Ability to work successfully within a structured, performance-driven environment
Strong self-awareness and coachability, including the ability to accept and apply feedback
Accountability for personal performance, learning, and development
Ability to work independently in a distraction-free environment
Work Environment & Expectations
Fully position requiring a quiet, dedicated, distraction-free workspace
Position involves extended periods of desk-based work, including screen time, keyboarding, and phone use
Continuous performance tracking, including:
Productivity
Quality
Adherence
Candidates must be comfortable working in a highly structured, closely monitored environment
Ability to troubleshoot minor technical issues independently, partner with IT as needed, and maintain accountability for timely follow-up and resolution of system issues
Education
Graduate of an accredited school of Practical Nursing (NLNAC or equivalent)
Must maintain active licensure in good standing
Please have candidates complete the following pre-screen and attach to top of resume in addition to other prescreen requirements listed at the top.
1. Do you currently hold an active, unrestricted LPN/LVN license? Yes No
2. Do you have 2 years of RECENT hands-on prior authorization experience (not scheduling, DME, surgery or procedure referrals, or intake)? Yes No
3. Which setting best describes your PA experience? (Select all that apply)
Pharmacy Benefit Manager
Specialty Medical Office
Health Plan
Hospital / Clinic (non-PA focused)
Hospice/Homecare/Private Duty
Private Medical Office
DME Prior Authorizations
Treatment/Imaging/Procedure/Surgical Authorizations
4. In your last PA role, were you responsible for reviewing clinical criteria and supporting documentation to make or support determinations? Yes No
Which types of clinical information did you review? (Select all that apply)
Clinical chart notes
Surgical/diagnostic reports
Lab results
Discharge Summaries
Prescription or Benefit Claims history
Prior authorization history
Medication criteria
None of the above
5. Which tools/programs have you used for PA processing? (Select all that apply)
Electronic authorization systems i.e. CoverMyMeds
Health plan portals and systems
EMR (Epic, Cerner, etc.)
Microsoft programs i.e Excel, Teams, OneNote, Word
Fax Management Systems
Paper Charts
None
6. On average, how many prior authorization cases for patients/members did you process per day?
?10
10–25
25–50
50
7. How many systems/screens did you regularly use at the same time? 1–2 3–4 5
8. Does your experience include:
Inbound provider calls/Member Calls/Patient Calls
Outbound calls to providers/pharmacies/Members/Patient
No call experience
9. Are you able to work consistently after training a scheduled work week which includes every weekend, business required overtime and adaptable to adhoc shift changes based on business need and trainings? Yes No
10.Training is Monday–Friday, 8:00 AM–4:30 PM CST for ~8 weeks. Can you attend 100% of training? Yes No

Position Summary:

Position Summary
We are seeking experienced LPN/LVN candidates with prior authorization experience in a specialty medical office (MDO), PBM, or clinical setting. This role requires the ability to work in a high-volume, metrics-driven environment while maintaining strong clinical judgment, accuracy, and efficiency.
Successful candidates are self-directed, resourceful, and adaptable, with the ability to quickly interpret clinical information, navigate multiple systems simultaneously, and maintain productivity while managing competing priorities. This is a fully role requiring a high level of accountability, focus, and independence throughout the entire shift.
Prescreen Requirements
Submit prescreen answers along with resume- for all questions
Provide internet speed and service type
Must be able to hardwire PC into modem/router
Submit copy of active LPN/LVN license with expiration date
Submit completed computer skills assessment with resume
Must have prior authorization experience in an MDO, PBM, or clinical setting
Training Schedule
Monday–Friday, 8:00 AM–4:30 PM CST
Training duration: 8 weeks (may extend due to holidays)
Permanent Schedule
Schedules are assigned based on business needs and may include:
Sunday–Thursday or Tuesday–Saturday
Shifts between 10:00 AM–6:30 PM CST
Schedule flexibility, overtime, and weekend availability are required.
Key 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 to changing priorities, processes, and clinical criteria
Communicate clearly and professionally with team members, pharmacists, providers, and leadership
Ask questions and seek clarification when needed to ensure accuracy
Maintain attention to detail while processing high volumes of work efficiently
Participate in quality assurance activities and apply feedback for continuous improvement
Perform work in a sedentary, desk-based environment requiring prolonged sitting, typing, and screen time
Maintain consistent attendance, productivity, and adherence to scheduled work hours
Required Qualifications
Active, unrestricted LPN/LVN license
Minimum 2 years of recent prior authorization experience in a PBM, MDO, or clinical setting
Experience reviewing and applying clinical criteria and supporting documentation for Client
Experience using CoverMyMeds or similar authorization platforms
Familiarity with chart notes, claims history, and insurance requirements
Technical Skills
Strong computer proficiency across multiple systems (Outlook, Teams, Word, Excel, etc.)
Ability to multitask across multiple monitors and applications simultaneously
Advanced keyboarding skills, with the ability to type quickly and accurately

Duties:

Position Summary
We are seeking experienced LPN/LVN candidates with prior authorization experience in a specialty medical office (MDO), PBM, or clinical setting. This role requires the ability to work in a high-volume, metrics-driven environment while maintaining strong clinical judgment, accuracy, and efficiency.
Successful candidates are self-directed, resourceful, and adaptable, with the ability to quickly interpret clinical information, navigate multiple systems simultaneously, and maintain productivity while managing competing priorities. This is a fully role requiring a high level of accountability, focus, and independence throughout the entire shift.
Prescreen Requirements
Submit prescreen answers along with resume- for all questions
Provide internet speed and service type
Must be able to hardwire PC into modem/router
Submit copy of active LPN/LVN license with expiration date
Submit completed computer skills assessment with resume
Must have prior authorization experience in an MDO, PBM, or clinical setting
Key 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 to changing priorities, processes, and clinical criteria
Communicate clearly and professionally with team members, pharmacists, providers, and leadership
Ask questions and seek clarification when needed to ensure accuracy
Maintain attention to detail while processing high volumes of work efficiently
Participate in quality assurance activities and apply feedback for continuous improvement
Perform work in a sedentary, desk-based environment requiring prolonged sitting, typing, and screen time
Maintain consistent attendance, productivity, and adherence to scheduled work hours
Technical Skills
Strong computer proficiency across multiple systems (Outlook, Teams, Word, Excel, etc.)
Ability to multitask across multiple monitors and applications simultaneously
Advanced keyboarding skills, with the ability to type quickly and accurately
Behavioral and Work Style Requirements
Proven ability to work in a fast-paced, high-production, metrics-driven environment
Strong attention to detail while maintaining speed and accuracy
Ability to learn quickly and work independently with limited guidance
Strong time management and organizational skills in a setting
Ability to remain focused and productive while working independently for full shifts
Comfortable working in a structured, highly monitored environment with performance metrics
Strong written and verbal communication skills, including the ability to clearly articulate clinical information and medication names
Ability to receive, apply, and act on real-time feedback
Work Environment & Expectations
Fully position requiring a quiet, dedicated, distraction-free workspace
Position involves extended periods of desk-based work, including screen time, keyboarding, and phone use
Continuous performance tracking, including:
o Productivity
o Quality
o Adherence
Candidates must be comfortable working in a highly structured, closely monitored environment
Ability to troubleshoot minor technical issues independently, partner with IT as needed, and maintain accountability for timely follow-up and

Experience:

Required Qualifications
Active, unrestricted LPN/LVN license
Minimum 2 years of recent prior authorization experience in a PBM, MDO, or clinical setting
Experience reviewing and applying clinical criteria and supporting documentation for Client
Experience using CoverMyMeds or similar authorization platforms
Familiarity with chart notes, claims history, and insurance requirements
Technical Skills
Strong computer proficiency across multiple systems (Outlook, Teams, Word, Excel, etc.)
Ability to multitask across multiple monitors and applications simultaneously
Advanced keyboarding skills, with the ability to type quickly and accurately
Behavioral and Work Style Requirements
Proven ability to work in a fast-paced, high-production, metrics-driven environment
Strong attention to detail while maintaining speed and accuracy
Ability to learn quickly and work independently with limited guidance
Strong time management and organizational skills in a setting
Ability to remain focused and productive while working independently for full shifts
Comfortable working in a structured, highly monitored environment with performance metrics
Strong written and verbal communication skills, including the ability to clearly articulate clinical information and medication names
Ability to receive, apply, and act on real-time feedback
Preferred Qualifications
3 years of prior authorization experience
Experience in a specialty medical office or with specialty medications
Broad clinical background across multiple disease states
Previous call center or high-volume clinical processing experience

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.

Registered Nurses (RNs) not accepted for LVN/LPN roles unless otherwise stated