Nurse Associate

CVS Health

CVS Health Nurse Associate reviewing clinical prior authorizations remotely from Arizona. Applying health plan criteria and collaborating with pharmacists and clinical teams.

Posted 8/4/2026full-timeRemote • Arizona • 🇺🇸 United StatesJuniorMid-Level💰 $22 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in reviewing and processing prior authorizations in compliance with CVS/Caremark policies and health plan criteria, while effectively managing communication and multitasking in a fast-paced environment. Holds an active LPN/LVN license and possesses strong problem-solving and clinical skills.

Highest-signal resume keywords

Active LPN/LVN LicensePrior Authorization ReviewClinical Criteria EvaluationMS Office ProficiencyExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior Authorization ProcessingClinical Documentation ReviewMultitaskingKeyboarding SkillsProblem-Solving Skills

Soft Skills

AdaptabilityUrgencyCollaborationPrioritizationResponsiveness

Tools & Technologies

Windows-Based ApplicationsWeb-Based ProcessingTelephony Programs

Certifications & Qualifications

Licensed Practical Nurse License

Industry Keywords

HealthcareQuality AssuranceRegulatory StandardsAccreditation StandardsPharmacy Benefits Manager

About the role

Key responsibilities & impact

Review complex clinical criteria-based prior authorizations electronically and/or in writing according to CVS/Caremark policies, procedures, and health plan/employer criteria
Refer cases that do not meet clinical criteria for upper-level review when appropriate
Manage calls, prior authorization requests, and ad hoc assignments with urgency and responsiveness
Follow prior authorization procedures and support business quality, regulatory, and accreditation standards
Participate in ongoing quality assurance activities, including reviewing work instructions and job aids
Collaborate with prior authorization representatives, pharmacists, clinical colleagues, healthcare professionals, clients, leaders, and team members
Complete additional prior authorization assignments delegated by leadership
Research documentation, communicate medical services, and make prior authorization determinations using clinical and problem-solving skills
Multitask and adapt effectively in a fast-paced changing environment
Work sedentary shifts involving telephone communication, multiple computer programs and screens, and keyboarding
Maintain regular and predictable attendance
Work required overtime and weekends when business needs require

Requirements

What you’ll need

Hold and maintain an active, unencumbered LPN/LVN license in the state of practice
Graduate of a State Agency-approved and/or NLNAC-accredited school of Practical Nursing
Hold a full, active, and unrestricted Licensed Practical Nurse license in a US state, territory, commonwealth, or the District of Columbia
Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria in a specialty/skilled clinical setting, such as a specialty medical office or Pharmacy Benefits Manager
Proficiency with computer skills, including multitasking, navigating multiple systems, and keyboarding
Experience using MS Office, Windows-based computer applications, web-based processing, and telephony programs
Excellent written and verbal communication skills
Ability to multitask, prioritize, and adapt to a fast-paced changing environment
Regular and predictable attendance
Ability to work business-required overtime and weekends when required

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being