[Hiring] Licensed Vocational Nurse @Iconma Portal

Role Description

• Review criteria-based prior authorizations following policy and procedure.
• Provide internal nurse support to the PA team and member services department.
• Refer cases not meeting clinical criteria to the Pharmacist and MD team(s).
• Shift priorities while exhibiting a high level of urgency with all calls and assignments.
• Work with pharmacists, other clinical colleagues, healthcare professionals, and members.
• Follow all prior authorization procedures to guarantee an accurate process on each prior authorization.
• Complete other PA assignments as delegated by the PA leadership team.
• Utilize clinical skills to support the documentation and communication of medical services and prior authorization determinations.
• Ability to multitask, prioritize, and effectively adapt to a fast-paced changing environment.
• This position involves sedentary work with periods of sitting, talking, and listening.
• Work requires sitting for extended periods, talking on the telephone, and typing on the computer.
• Position requires proficiency with computer skills which include navigating multiple systems and keyboarding.
• Excellent communication skills, both written and verbal.
• Must have regular and predictable attendance.
• Perform and handle inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve calls with a one-call solution.
• Perform other related projects and duties as assigned, including attending training sessions and development meetings.

Qualifications

• Minimum 2 years clinical experience as a LPN/LVN.
• A LVN (Licensed Vocational Nurse) or LPN (Licensed Practical Nurse) that must hold an unrestricted license in their state of residence or a compact license.
• Prior authorization experience or Case Management experience.
• 3+ years prior related clinical work experience.
• Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations.
• Experience using MS Office and other Windows-based computer applications and phone use.
• Digital charting.
• Managed care or health plan previous experience.
• Call center experience.
• Multi-tasking experience.
• Prior remote experience preferred.
• Case Management experience.
• Prior authorization experience.
• High production experience.
• Excellent organizational skills. Strong detail orientation.

Benefits

• Health Benefits.
• Referral Program.
• Excellent growth and advancement opportunities.