We’re on a mission to improve health outcomes and reduce the cost of care. The work of our medical department is critical to helping us do both. Working in a call center environment under supervision, this position handles inbound calls from patients, patient representatives, providers, and other medical staff. The schedule for this position is Monday-Friday, 8:00am-5:00pm. Training will take place at our company headquarters for 90 days before transitioning to a fully remote setting.

What the Pre-certification Licensed Practical Nurse will add to the team:

  • Management of precertification processes of eligible medical services based on medical plan documents and medical necessity
  • Apply clinical knowledge to make determinations for pre-authorizations of specific procedures and services
  • Conduct Medical/Surgical medical necessity reviews
  • Verify and update patient information in the clinical information system
  • Attention to detail and a team-focused attitude

What the ideal Pre-certification Licensed Practical Nurse will bring:

  • Associates degree or higher
  • Current LPN certification in North Carolina
  • Two or more years of healthcare experience and utilization review or related experience preferred
  • Excellent communication skills with members and providers
  • Spanish-speaking candidates are preferred