LPN Preauthorization in Flemington, New Jersey at Hunterdon Health Care System

LPN Preauthorization

Position Summary

The Licensed Practical Nurse (LPN) will play a key role in supporting a newly developed centralized process for medication priorauthorizations across the medical group. This role will ensure timely, accurate, and patient-centered completion of prior auth requests while collaborating closely with providers, clinical staff, payers, and pharmacy teams. The LPN may also provide clinical support for phone triage, patient communication, and float coverage across HMG offices as needed. As this is a new pilot position, responsibilities may evolve as workflows are optimized and the centralized model develops.

Primary Position Responsibilities

1. Coordinate and complete medication prior authorizations in compliance with payer requirements and organizational processes.
2. Work collaboratively with providers and care teams to gather clinical information needed for prior auth submissions.
3. Communicate with patients, pharmacies, and payers regarding the status of medication requests and required next steps.
4. Utilize EMR and payer portals to track, manage, and document prior authorization activities.
5. Provide support for clinical phone triage, including reviewing patient concerns, relaying provider instructions, and scheduling follow-up as appropriate.
6. Assist with float coverage in HMG practices to ensure continuity of care during staffing gaps.
7. Participate in process improvement efforts to strengthen the centralized prior authorization model. 8. Maintain knowledge of current clinical and payer guidelines relevant to medication management.
9 . Perform additional duties within scope of licensure to support operational and clinical needs as the role expands.

Work Contact Group (Internal/External)

Patients & Families, HMC Employees, Healthcare Providers, Visitors, Insurrance

Reporting Relationships

Reports to (position):

Supervisor of Operations Admin Director of Primary Care

Supervises (position(s):

None

Qualifications

Minimum Education:

Required:

Nursing Diploma

Preferred:

Associate’s Degree in Nursing

Associate’s Degree in Nursing

Minimum Years of Experience (Amount, Type and Variation):

Required:

1-2 years of clinical experience in an outpatient or medical group setting preferred.

Preferred:

None

License, Registry or Certification:

Required:

Current New Jersey LPN License, CPR certified or obtain certification within 6 months

Preferred:

None

Knowledge, Skills and/or Abilities:

Required:

Good communication and interpersonal skills, decision making ability, telephone etiquette, detail and multitasking oriented, ability to handle a high volume of patients. Ability to work both independently and Proficiency with electronic medical records and payer portals. Strong organizational skills and attention to and collaboratively in a fast-paced environment. Interest in helping to build and refine new workflows. Flexible and adaptable as the centralized pilot evolves.

Preferred:

Proficiency with electronic medical records and payer portals. Strong organizational skills and attention to detail. Comfortable navigating complex payer rules and advocating for patient access.

Hunterdon Health is committed to providing a competitive benefit package to our employees. Benefit offerings vary based on status and may include but not be limited to medical, dental, vision, family forming, paid time off, tuition reimbursement, and retirement savings.

The hiring range listed is the potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining an applicant’s hourly rate and/or base salary, several factors may be considered as applicable (e.g., years of relevant experience, education, internal equity, and specialty).