PRIOR AUTHORIZATION RN / LPN - SCC PRIMARY CARE SERVICES

Registered Nurse / Licensed Practical Nurse -

Prior Authorization Job Title:

Registered Nurse -

Prior Authorization Department:

Primary Care Services Full Time/PRN:

Full Time Job Summary Manages medication prior authorizations and patient assistance programs; coordinates with providers, insurers, and manufacturers; documents and monitors approvals, appeals, and renewals; ensures HIPAA compliance. Minimum Qualifications Active RN or LPN; experience in prior authorization/case management/utilization review; EMR proficiency. Preferred Qualifications Experience in primary/specialty clinics; familiarity with SCRMC processes. Essential Duties & Responsibilities Complete prior auth requests and submissions. Establish/maintain manufacturer drug programs. Communicate with insurers, manufacturers, providers, and patients. Track outcomes; manage appeals. Collaborate with pharmacy/billing/clinical teams. Physical Requirements Prolonged periods of sitting and computer work. Occasional standing, walking, bending, and reaching. Lift up to 25 lbs occasionally (files/supplies). Adequate vision, hearing, and speech to perform job duties and communicate effectively. All candidates must be able to perform the essential functions of this position. The American with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to help perform the essential functions of the position. South Central Regional Medical Center is an equal opportunity employer and does not discriminate based on race, color, religion, sex, gender, national origin, age, disability, or genetic information.